Every finding on record at Elysium Hospice Care, Inc.

Upon patient record review, 3 of 19 (Patient #4,5,11) did not have evidence in the patient record that hospice aide assignments and duties are: • Assigned to a specific patient by a registered nurse that is a member of the interdisciplinary group • Written patient care instructions for a hospice aide must be prepared by a Registered Nurse who is responsible for the supervision of a hospice aide as specified under paragraph (h) of 418.76 • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. The use of “PRN” or “per patient choice”, for any task, whether personal care or non-personal care tasks, are not acceptable Patient #4: There is evidence in the medical record of an order 4/8/25 for Plavix 75 mg daily. The home health aide plan of care did not include bleeding precautions. Patient #5: There is evidence in the medical record of an order 2/11/25 for Plavix 75 mg daily. The home health aide plan of care did not include bleeding precautions. Patient #11: There is evidence in the medical record of an order 6/6/25 for Plavix 75 mg daily. The home health aide plan of care did not include bleeding precautions.

Upon client record review, 3 of 13 records (Patient #2, #6, #10) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #2: The IDG visits routinely (Nurse 1xwk, Aide 3xwk, MSW 1xmo, SC 1xmo); however there was no order for visits generated for the 5/4/22-7/2/22 recertification period. Corrected on-site with clarification order. Patient #6: The IDG visits routinely (Nurse 1xwk, Aide 3xwk, MSW 1xmo, SC 1xmo); however there was no order for visits generated for the 4/21/22-7/19/22 recertification period. Corrected on-site with clarification order. Patient #7: The IDG visits routinely (Nurse 1xwk, Aide 3xwk, MSW 1xmo, SC 1xmo); however there was no order for visits generated for the 5/25/22-8/22/22 recertification period. Corrected onsite with clarification order.

Upon observation, there was no evidence the hospice follows acceptable standards of practice to prevent the transmission of infections and communicable diseases, including standard precautions. Patient #3: Upon arriving at the patients home, the chaplain did not wash hands or use hand gel. Agency policy 6-006.1 states that to prevent cross contamination and home care acquired infections personnel providing care in the home setting will regularly wash their hands using an alcohol based hand rub or wash hands with an antimicrobial soap and water.

Upon personnel record review, 1 of 2 applicable personnel records (Personnel #6) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient for all assigned tasks. Personnel #6: There was no evidence that the aide was evaluated by observation for competency in transferring patient per mechanical lift prior to being assigned to the patient (Patient #7 had a mechanical lift).

Upon patient record review, 1 of 13 (Patient #1) did not have evidence in the patient record that hospice aide assignments and duties are: Patient #1: Aide Care Plan was unclear regarding patients functional status. Both "Ambulates with walker" and "bedbound" documented by the RN.

Upon patient client record review, 5 of 13 records (Patient #1, #5, #9, #10, #12, #13) 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 #1,5,9,10,13: The record did not have evidence that the consent was completed with the reason why the beneficiary could not sign. Patient #12 The 4/5 Death note stated there were no meds to destroy; however the patient had a comfort pack containing Morphine Sulfate and Lorazepam in the home.