Deficiency Index

Every finding on record at Fate Hospice Inc

Glendale, California · CCN B31717

4 findings across 2 surveys, in the inspector's own words.

The inspector’s own words from form CMS-2567, unedited, including CMS’s own spacing. Names and some dates are redacted by CMS.

Survey of May 2, 2025

3 findings
L0544

Upon patient record review, 1 of 14 (Patient #1) did not have evidence that each patient and family received education and training provided as appropriate to their responsibilities for the care and services identified in the plan of care. Patient #1: The medical record included documentation and an order dated for 12/23/24 for Rocephin to be given daily through 01/03/25 intravenously through an 18g angiocath placed in the upper left arm of the patient. The medical record showed no evidence that there was training regarding dose, side effects or management of the IV site. to the patient/family/caregiver.

L0550

Upon patient record review, 1 of 14 (Patient #10) 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 equipment and supply needs. Patient #10: Upon patient record review, the Nursing Comprehensive dated 02/02/25, noted patient was incontinent of bowel and bladder and utilized incontinent supplies, specifically diapers. There were no incontinent supplies listed on patients plan of care.

L0555

Upon patient record review, 1 of 14 (Patient #1) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #1: Upon record review, there was evidence of a medication Rocephin administered via IVP daily starting 12/23/24 through 01/03/25. This medication was noted on patient's plan of care along with an MD order for RN visits daily from 12/23/24 - 01/03/25. Frequency of visits were met, however there were no indication in the visit documentation that this medication was provided. Visit notes dated 12/25/25 and 12/28/25, had documentation regarding medication administration, other visit dates had no indication of this medication administration or assessment of IV site.

Survey of March 16, 2022

1 finding
L0615

Upon personnel record review, 1 of 1 applicable (Personnel #5) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient. Personnel Record #5 HA Competency checklist used does not differentiate types of shampoo to include sink, tub, bed shampoos.

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Federal survey findings only. State licensure findings for hospices are not shown.

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