Every finding on record at Excellence Hospice Providers, Inc.

Observed in Record Review. In 7 of 7 patient records reviewed, During the record review, in 7 of 7 records, the Hospice surveyor noted that that the organization did not have measureable goals. For example, the verbiage included optimum level of independence, optimum peripheral circulation, satisfaction with bowel elimination and prevent discomfort R/T increased edema. This was validated in a discussion with and observation by the Alternate Administrator and the DPCS.

Observed in Record Review. During the record review, in 7 of 7 records, the Hospice surveyor noted that that the organization did not have specific frequencies. For example, the orders were written and PRN with no specific number. This was validated in a discussion with and observation by the Alternate Administrator and the DPCS.

Observed in Record Review. In 1 of 11 patient records reviewed, The organization failed to ensure the record was complete and accurately documented. For example: in RR#5 the physicians narrative for the 7th benefit period contains similar documentation for the 6th benefit period to include dates of the previous benefit period and the date of the previous BP's face to face visit. This observation was reviewed with the Administrator and the Director of Nursing.

Observed in Record Review. In 2 of 11 patient records reviewed, The organization failed to ensure the care was provided in accordance with the plan of care. For example: upon review of the record for HV#2, it was noted that in week 3 of benefit period 7, the LVN educated the Pt caregiver in the use of Amitiza and Miralax in response to issues with constipation. There is no indication there were orders for the Amitiza and Miralax, and the medications were not included on the medication profile. This observation was reviewed with the Administrator, and the Director of Nursing. Observed in Record Review. In 2 of 11 patient records reviewed, The organization failed to ensure care and services were provided in accordance with the established plan of care. For example: in RR#3 the aide assignment specifies bath to be given via a shower chair yet in every aide visit since admission the aide documented in the comments that a bed bath was completed. This observation was reviewed with the Administrator and the Director of nursing.

Observed in Record Review. In 2 of 11 patient records reviewed, The organization failed to evaluate the patient/caregiver's understanding of education and training provided. For example: in RR#2 the SN documents the caregiver is competent and knowledgeable to administer insulin and monitor blood glucose, yet there is no indication of how the proficiency was assessed such as return demonstration. In RR#1 the SN indicated the caregiver is competent and knowledgeable in providing wound care treatments ordered. There is no indication how proficiency is demonstrated such as return demonstration. This observation was reviewed with the Administrator and the Director of Nursing.

Observed in Record Review. In 1 of 11 patient records reviewed, The organization failed to comply with applicable laws as related to the Notice of Medicare Non-Coverage form for Hospice discharge. For example: upon review of the discharge of RR#7 for extended prognosis, the NOMNC was signed on the day of discharge not allowing for the at least 48 hour notice as required by regulation. This observation was reviewed with the Administrator and the Director of Nursing.