Every finding on record at Community Health Concepts, LLC

It is required that a hospice aide provides services ordered by the Interdisciplinary Group and included in the plan of care. This standard was not met as evidenced by clinical record review and interview. In 2 of 12 (17%) clinical records reviewed, the agency did not ensure the aide provided services as ordered by the interdisciplinary group and included in the plan of care. Clinical Record 2: The patient elected the hospice benefit dated 7/31/2023, with a terminal diagnosis of senile degeneration of brain. The aide plan of care assignment dated 7/31/2023, assigned the aide to provide nail care to the patient each week. The week of 8/30/2023 through 8/5/2023, the aide documented nail care was performed at each aide visit dated 8/1/2023, 8/2/2023, and 8/3/2023. In a joint review of clinical record and interview, the Clinical Manager agreed that the aide did not follow the plan of care assignment as ordered. Clinical Record 3: The patient elected the hospice benefit dated 8/2/2023, with a diagnosis of senile degermation of brain. The aide plan of care assignment dated 8/2/2023, assigned the aide to provide bathing, hair care, nail care and shampoo to the patient each week. Review of aide visit notes revealed the aide performed these tasks on aide visits dated 8/3/2023 and 8/4/2023, two times in one week and on aide visits dated 8/7/2023, 8/8/2023, and 8/9/2023, three times in one week. In a joint review of clinical record and interview, the Clinical Manager agreed that the aide did not follow the plan of care assignment as ordered.

It is required that the designated IDG member provides the SNF/NF or ICF/IDF with the following information for each patient/resident, the most recent hospice plan of care. This standard was not met as evidenced by observation and interview. In 2 of 2 (100%) home visit observations of patients that reside in a skilled nursing facility (SNF), the agency did not ensure the designated IDG [interdisciplinary group] member provided the SNF with the most recent plan of care. Home Visit 1: The patient elected the hospice benefit dated 8/2/2023, with a terminal diagnosis of senile degeneration of brain. The patient resided in a SNF. During a home visit observation with the hospice aide, the patient’s hospice binder at the SNF was reviewed. There was no documented evidence in the hospice binder that the SNF was provided the most recent hospice plan of care. The most recent hospice plan of care in the binder was dated 2/16/2023. Home Visit 2: The patient elected the hospice benefit dated 7/31/2023, with a terminal diagnosis of senile degeneration of brain. The patient resided in a SNF. During a home visit observation with the social worker, the patient’s hospice binder at the SNF was reviewed. There was no documented evidence in the hospice binder that the SNF was provided the most recent hospice plan of care. The most recent hospice plan of care in the binder was dated 2/16/2023. In an interview the Director of Operations/Clinical stated it was the agency's policy to keep updated plans of care in the facility. It is the interdisciplinary team's responsibility to keep all the paperwork up to date. These patients were a transfer from another hospice location. In an interview with the director she stated it was the agency policy to keep updated plans of care in the facility. It is the interdisciplinary teams responsibility to keep all the paperwork up to date.