Every finding on record at Cfhc No22 Inc

It is required that hospice aides are assigned to a specific patient by a registered nurse who is a member of the Interdisciplinary Group. Written patient care instructions for a hospice aide are prepared by a RN who is responsible for the supervision of the hospice aide. This standard was not met as evidenced by clinical record review and interview. In 2 of 3 (67%) clinical records reviewed of patients who received hospice aide services, it was revealed that the agency did not ensure that the hospice aide care plans contained a description of all care and services to meet the patient's assessed needs. Clinical Record 3: The patient's date of hospice election was 3/27/23 with a primary diagnosis of Heart Disease. The initial comprehensive nursing assessment was performed by the RN on 3/27/23 and the patient was assessed for fall risk using the MAHC-10 tool. The patient was determined to have a fall risk score of "6" and the EMR stated that the patient was "At risk for falls" with this score. There was no documentation that addressed fall precautions or safety measures related to falls present on the aide plan of care dated 3/27/23. Clinical Record 6: The patient's date of hospice election was 3/30/23 with a primary diagnosis of Heart Failure. The initial comprehensive nursing assessment was performed by the RN on 3/30/23 and the patient was assessed for fall risk using the MAHC-10 tool. The patient was determined to have a fall risk score of "7" and the EMR stated that the patient was "At risk for falls" with this score. There was no documentation that addressed fall precautions or safety measures related to falls present on the aide plan of care dated 3/30/23. During an interview on 6/1/23, the Registered Nurse Case Manager (Staff 3) confirmed that fall precautions and safety measures were not included on the hospice aide care plans of these patients.

It is required that a hospice aide provides services: Ordered by the Interdisciplinary Group; Included in the plan of care; Permitted to be performed under state law and regulation; and Consistent with the hospice aide training. This standard was not met as evidenced by clinical record review and interview. In 1 of 3 (33%) clinical records reviewed of patients who received hospice aide services it was revealed that the agency did not ensure that aide visits were provided in accordance with the ordered visit frequency for the hospice aide documented on the plans of care. Clinical Record 4: The patient's date of hospice election was 5/11/23 with a primary diagnosis of cerebral infarction. The initial plan of care dated 5/11/23 ordered the hospice aide at a visit frequency of 3 times per week times 2 weeks. Clinical documentation revealed that the aide visited on 5/12/23 with no documented evidence of 2 additional aide visits completed, as ordered, during the first week of service, which ended on 5/13/2023. During an interview on 6/1/23, the Nurse Case Manager (Staff 3) stated that the hospice aide visits performed did not match the ordered hospice aide visit frequency.