Every finding on record at Clear Path Hospice of Wichita LLC

Based on document review, policy review and interview, the hospice failed to ensure Hospice aid written patient care instructions for the hospice aide were prepared by an RN who is responsible for the supervision of a hospice aide for 2 (Patients 6 and 8) of 10 current patient records reviewed and 1 (Patient 13) of 4 discharged patient records reviewed. The hospices failure to ensure the RN prepared written care instructions for the hospice aide has the potential to place patients at risk for ongoing, unmet personal care services and needs. --- Findings Include: Review of a Hospice policy titled, ";Home Health Aide Plan of Care -1016 Policy," showed the Hospice home health aide services would be delivered by hospice aides under the direction of the interdisciplinary group and supervised by a registered nurse/case manager. The home health aide assignment/plan of care would be updated when there was a change in the status or needs of the patient and the registered nurse would rewrite the home health aide assignment and finalize the document. Review of a Hospice policy titled, ";Hospice Aide Services -0100 Policy," showed the hospice aide would follow an individualized assignment sheet for each patient and that the aide would follow the assigned duties and only the duties on the Plan of Care. Patient 6 Review of the ";Combined Disciplinary Plan of Care," updated by the Interdisciplinary Group (IDG) on 07/14/23 for the Certification Period: 06/09/23 to 09/06/23 showed the patient needed assistance with activities of daily living (ADLs). Intervention: Hospice Aide to provide care according to assignment; Aide will provide care for patient for personal ADLs; IDG approval for Hospice Aide visit frequency of 2 visits per week; Start Date June 6, 2023. There were no written patient care instructions for the hospice aide noted on the Combined Disciplinary Plan of Care. Review of the ";Hospice Aide Visit Note" completed by Staff B on the following dates (06/13, 06/16, 06/23, 06/27, 06/30, 07/4, 07/7, 07/11, 07/14, and 07/18/23) showed personal care services were completed by the Hospice Aide at a frequency of two times per week. Patient 8 Review of the ";Combined Disciplinary Plan of Care," updated by the Interdisciplinary Group (IDG) on 07/14/23 for the Certification Period: 06/22/23 to 09/19/23 showed the patient needed assistance with all activities of daily living (ADLs), walked with a walker and must be accompanied by a caregiver due to decrease mobility and strength. Intervention: Hospice Aide to provide care according to assignment; Hospice Aide will assist with ADLs; IDG approval for Hospice Aide visit frequency of 1 visit per week; Start Date 06/25/23. There were no written patient care instructions for the hospice aide noted on the Combined Disciplinary Plan of Care. Review of the ";Hospice Aide Visit Note" completed by Staff B on the following dates (6/27, 7/4, and 7/12) showed personal care services were completed by the Hospice Aide weekly. There was no documentation to support a Hospice Aide Assignment (written Hospice Aide instructions/care plan) was completed, signed nor updated by the RN for written instructions for the provision of HHA services. Patient 13 Review of the ";Combined Disciplinary Plan of Care," updated by the Interdisciplinary Group (IDG) on 09/16/22 for the Certification Period: 09/11/22 to 12/09/22 showed the patient needed assistance with activities of daily living (ADLs) and required assistance of one with transfers. Intervention: Hospice Aide to provide care according to assignment; IDG approval for Hospice Aide visit frequency of 1 visit per week; Start Date 09/11/22. There were no written patient care instructions for the hospice aide noted on the Combined Disciplinary Plan of Care. Review of the ";Hospice Aide Visit Note" completed by Staff C on the following dates (09/11/22 and 09/19/22) showed personal care services were completed by the Hospice Aide weekly. There was no documentation to support a Hospice Aide Assignment (written Hospice Aide instructions/care plan) was completed, signed nor updated by the RN for written instructions for the provision of HHA services. During an interview on 07/21/23 at 10:40 AM, Staff A, Administrator, reviewed the medical records for the patients and confirmed that a Hospice Aide Assignment had not been completed by the Registered Nurse.