Every finding on record at Dove Hospice Services of Pennsylvania, LLC

Based on review of agency policy, clinical records (CR) interview with the Clinical Director, the hospice failed to follow the Hospice Plan of Care and/or Physician orders for one (1) of fourteen (14) clinical records (CR #14). --- Findings include: Agency policies were reviewed on 8/8/24 at approximately 10:00 AM and revealed the following. Policy titled, ";Interdisciplinary Group Plan of Care" stated, ";The hospice interdisciplinary group with retain professional management responsibilities for the provision of services, including inpatient care, and will insure that services are furnished in a safe and effective manner..." Policy titled ";Certified Nursing Assistant: Job Description Summary" stated, ";The certified Nursing Assistant is a paraprofessional member of the interdisciplinary group who works under the supervision of a registered nurse and performs various services for a patient as necessary to meet the patients personal needs and to promote comfort...Essential Job Functions/Responsibilities...meeting safety needs of patient and using equipment safely and properly...assisting in feeding the patient as assigned..." Policy titled, ";The Plan of Care" stated, ";The care provided to the patient must be in accordance with the plan of care...This plan will focus on identified problems, goals and interventions...Any change in the patients condition must result in a change in the plan of care, prior to implementation of the new service..." A review of fourteen (14) CRs were reviewed onsite on 8/6/24 starting at approximately 1:00PM, 8/7/24 at approximately 9:30AM, 8/8/24 at approximately 10:00am, and offsite on 8/9/24 and 8/12/24 at approximately 11:00 which revealed the following: CR #14: Start of Care (SOC): 2/26/24. Contained a Hospice plan of care for the certification period of 8/2/24-9/30/24 that stated Hospice Aide once weekly for one week then five times weekly for nine weeks. The hospice plan of care also stated ";Nutrition: Puree Diet...Interventions. Aide: Diet: Other: puree diet with thin liquids...Aide: Safety...aspiration precautions (measures taken to help prevent choking)...psych consult eval to be performed to determine competency, swallow eval to be completed to reassess diet restrictions." Aide Care plan states, ";Diet...puree diet and think liquids..." ";Employee Disciplinary Notice" dated 7/17/24 stated, ";Employee Name: (PF#9). Description of event: Pt (patient) was given soft snack while on pureed diet by Hospice Aide...Management Statement, ";Education and written warning provided to (PF#9) regarding dietary orders, aspiration and choking hazards. Meeting with DON (Director of Nursing at CR#14s Nursing Home) discussed situation and provided documentation..." ";Patient, Family, Visitor Incident Report" dated 7/17/24 stated, ";Pt (patient) was given soft snack on 7/16/24 by hospice aide (PF#9) while pt was on a pureed diet. Spoke (with) daughter (daughters name) and DON (director of nursing at CR#14s nursing home) regarding incident. Education and written warning given to (PF#9) regarding dietary orders, aspiration and choking hazards, all hospice documentation and written waring provided to DON (at CR#14s nursing home). Handwritten note (no date) stated, ";Pt is on a puree diet. Pt asked for apple pie, coffee, juice. I brought him a small Danish that was soft, coffee and an orange juice. Pt is on regular liquids. Pt took bites and did not choke.." Note is signed by PF#9 An interview with the agency's Clinical Director on 8/8/24 at approximately 3:00 pm confirmed the above findings.