Every finding on record at Eagles Nest Palliative Hospice LLC

Upon observation, there was no evidence the hospice documented the cost savings achieved through the use of volunteers. Documentation must include the following: • The identification of each position that is occupied by a volunteer • The work time spent by volunteers occupying those positions • Estimates of the dollar costs that the hospice would have incurred if paid employees occupied the positions identified in paragraph (d)(1) of CFR 418.78 for the amount of time specified in paragraph (d)(2) of CFR 418.78 The agency had records of monthly volunteer hours. The reports did not include the % of total patient care hours of all paid hospice employees and contract personnel. The report also did not include the cost savings achieved through use of volunteers.

Upon patient record review, 2 of 5 (Patient #1, 2) did not have evidence that all entries are legible, clear, complete, and appropriately authenticated and dated in accordance with the organizations policies and procedures and currently accepted standards of practice. Electronic signatures are acceptable as long the hospice is following appropriate safeguards to prevent unauthorized access to the patient records. Patient #1: The patient record included a blank ABN that was partially filled out and signed on admission. Patient #2: The patient record included a blank ABN that was partially filled out and signed on admission.

Upon patient record review, 5 of 5 (Patient #1, 2, 3, 4, 5) did not have evidence in the patient record that the interdisciplinary group, as part of the review of the plan of care, determines the ability of the patient and/or family to safely self-administer drugs and biologicals to the patient in his or her home. If the patient and/or family are not capable of safely administering drugs and biologicals in the home, the hospice must address this issue in the patient's plan of care. Patients 1, 2, 3, 4, 5: The initial nursing assessment does not show that the nurse determined the patient or family ability to self administer drugs and biologicals to the patient. This was also not reflected in the patient POC. The assessment had a checkbox that stated "patient/caregiver safely administer medications" there is no evidence that it was assessed.