Every finding on record at Chosen Hospice Care

Upon patient record review, 1 of 14 (Patient #5) did not have evidence in the patient record that the comprehensive assessment is updated including and by: • The hospice interdisciplinary group (in collaboration with the individual's attending physician, if any) • Changes that have taken place since the initial assessment • Information on the patient's progress toward desired outcomes • Reassessment of the patient's response to care • The assessment update must be accomplished as frequently as the condition of the patient requires, but no less frequently than every 15 days Patient #5, No evidence of continuous assessment of patient. RN visits ordered every 14 days, on 1/1/25, 1/15/25,1/29/25, all visits were supervisory visits only. No RN assessment was completed on those dates.

Upon patient record review, 2 of 14 (Patient #5,8) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient #5,8, Patient was identified as a full code. No evidence of full code addressed under psychosocial care plan.

Upon client record review, 1 of 14 (Patient #5) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #5, Patient admitted on 5/18/25, Admission order documented on 5/18/25 states to notify MD if SBP is greater than 160. Upon assessment of patient blood pressure was 164/84. No evidence of MD was notified of elevated blood pressure.

Upon personnel record review, 1 of 12 (Personnel #4) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: (This standard applies to all Hospice Aides providing care/service who are directly employed by the hospice or through a contractual agreement.) ·Communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other hospice staff. ·Reading and recording temperature, pulse, and respiration ·Safe transfer techniques and ambulation. ·Normal range of motion and positioning ·Appropriate and safe techniques in personal hygiene and grooming that include-- ·(A) Bed bath ·(B) Sponge, tub, and shower bath ·(C) Shampoo, sink, tub, and bed ·(D) Nail and skin care ·(E) Oral hygiene ·(F) Toileting and elimination The other subject areas in this section may be evaluated through written examination, oral examination or after observation of a Hospice Aide with a patient. Personnel #4, No evidence above tasks where observed, competency has documentation as verbalization only.

Upon patient record review 2 of 14 (Patient #5,8) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient #5, Care plan directions were to complete tidy room/empty trash. No evidence these items were completed on aide documentation on 11/19/24. Patient #8, Care plan directions were to complete change linens, tidy room/empty trash. No evidence these items were completed on aide documentation on 7/25/24.