Every finding on record at Continuum Care of Rhode Island, LLC

Upon patient record review, 2 of 19 (Patient #6, 12) did not have evidence the plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions, including medications and treatments. Patient #6: 9/15/25 order coccyx PU (pressure ulcer) Stage 2, cleanse with NS pat dry, cover with Xeroform and 3x3 Alevyn dressing 3x/week and PRN, PRN not qualified. 9/22/25 small open area midline lower back, Cleanse with NS. Apply small amount of barrier cream and cover with 3x3 foam dressing 3x/week and PRN. PRN is not qualified 9/22/25 order obtained to change foley catheter 1x/month and as needed. As needed is not qualified. Patient #12. IDG Care Plan orders for wound care: 9/9/25 left dorsal foot skin tear, skin prep daily and PRN. 8/25/25 Right cheek lesion, apply A and D ointment daily and PRN and right lateral 5th toe, apply A and D ointment daily and PRN. PRN is not qualified.

Upon client record review, 3 of 19 (Patient #6, 10, 14) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #6: SOC 8/13/25 with indwelling catheter in place. 8/13/25 order to insert catheter and change as prescribed ...16 Fr. 10 ml balloon. A new catheter was not inserted. Per staff interview, the order to insert catheter was not the intent, but to maintain existing catheter. Patient #10: 7/9/25 order for Volunteer 3mo1 with order discontinued 7/31/25. Visits made 7/10 and 7/18/25 only. There is no documented effort to restaff, or reschedule same week in accordance with PC.C75 Missed Visits Policy. Patient #14: SC frequency 8/12/25 of every 60 days. Patient was seen 8/2/25 (initial) and revisited 9/12/25.

Upon patient record review 1 of 19 (Patient #10) did not have evidence that the IDG ensures that the care and services provided are based on all assessments of the patient and family needs. Patient #10: IDG note 7/16 by VC says patient benefits from volunteer companionship support visits and 8/27/25 IDG patient benefits from volunteer companionship support visits yet no evidence IDG ensures needs of patient met as volunteer services were discontinued end of July.

Upon patient record review 2 of 19 (Patient #3, 4) 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 #3: Documented missed Hospice Aide visit 8/23, 9/18/25. There is no documented effort to restaff, or reschedule same week in accordance with PC.C75 Missed Visits Policy. Patient #4: Hospice Aide Freq of 4/week. Missed Hospice Aide visit week of 7/28/25. There is no documented effort to restaff, or reschedule same week in accordance with PC.C75 Missed Visits Policy.

Upon patient client record review, 4 of 19 (Patient #12, 14, 17, 18) did not have evidence that each patient record contains Advance Directives. Patient #12, 14, 17, 18: Patient identified as DNR in medical record /care plan with no documented evidence of DNR/MOLST form in record.

Upon personnel record review, 1 of 1 applicable (Personnel #9) did not have evidence that all Speech Therapy Services are provided by a qualified licensed Speech-Language Pathologist (SLP) or Audiologist in accordance with the state's Speech-Language Pathology Practice Act and the hospice's policies and procedures and/or job descriptions. Personnel #9: There was no ST personnel record available to ensure services were provided by a qualified licensed Speech Therapist.

Upon personnel record review, 1 of 1 applicable (Personnel #8) did not have evidence all Occupational Therapy Services are provided by a qualified licensed Occupational Therapist (OT) in accordance with the state's Occupational Therapy Practice Act and the hospice's policies and procedures and/or job descriptions. Personnel #8: There was no OT personnel record available to ensure services were provided by a qualified licensed Occupational Therapist.

Upon personnel record review, 1 of 1 applicable (Personnel #7) did not have evidence all Physical Therapy Services are provided by a qualified licensed Physical Therapist (PT) in accordance with the state's Physical Therapy Practice Act and the hospice's policies and procedures and/or job descriptions. Personnel #7: There was no PT personnel record available to ensure services were provided by a qualified licensed Physical Therapist.

Upon personnel record review, 3 of 4 applicable (Personnel #7, #8 and #9) did not have evidence the hospice obtained a criminal background check on all contracted individuals who have direct patient care and access to patient records. Personnel #7, #8 and #9: There were no personnel records available for review to verify background checks had been obtained for PT, OT and ST.

Upon personnel record review, 3 of 14 (Personnel #7, #8 and #9) did not have evidence the hospice obtained proof of the covid vaccination on all contracted individuals who have direct patient care and access to patient records. Personnel #7, #8 and #9: There were no personnel records available for review to verify the covid vaccination status for PT, OT and ST.