Every finding on record at Gaia Hospice, Inc.

Upon observation, there was no evidence that during the initial assessment visit in advance of furnishing care, the hospice provided the patient and/or family with verbal (meaning spoken) and written notice of the Patient's Rights and Responsibilities in a language and manner that the patient understands. Patient #2,3: During patient visits there was no evidence of the patient being provided a copy of rights and responsibilities in their native language of Armenian. Both patients and caregivers were unable to speak or read English.

Upon patient record review, 3 of 14 (Patients #3, 4, 9) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient #3: The patient is on service with hypertensive heart disease, the assessment showed that the patient suffers with BLE edema. There are no interventions or goals for edema on the cardiac POC. Patient 4: The patient is on service with heart failure. The patient is taking narcotics for pain relief. There are no interventions or goals for prevention of constipation with opiate pain medication use. Patient #9: The patient is on service for COPD. The assessment states that patient is only alert and oriented to person and place. There are no interventions or goals related to orientation and confusion episodes.

Upon patient record review, 4 of 14 (Patients #6, 7, 8, 9) did not have evidence that the IDG in collaboration with the attending physician reviewed, revised and documents the individualized plan as frequently as the patient's condition requires but no less frequently then every 15 calendar days. Patient #6: There is evidence that the RN created the IDG note, she did not sign the IDG for the dates of 03/26/25, 03/12/25, or 02/26/25. the MSW did not sign the IDG for 03/12 and 03/26/25. Patient #7: There is evidence that the RN created the IDG note, the RN and MSW did not sign the IDG for the dates of 04/09/25, 03/26/25, and 03/12/25. Patient #8: There is evidence that the RN created the IDG note, the RN did not sign the IDG for the dates of 04/09/25, 03/26/25, and 03/12/25. Patient #9: There is evidence that the RN created the IDG note, the RN did not sign the IDG for the dates of 04/09/25, 03/26/25, and 03/12/25.

Upon personnel record review, 1 of 12 (Personnel #10) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: (This standard applies to all Hospice Aides providing care/service who are directly employed by the hospice or through a contractual agreement.) ·Communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other hospice staff. ·Reading and recording temperature, pulse, and respiration ·Safe transfer techniques and ambulation. ·Normal range of motion and positioning ·Appropriate and safe techniques in personal hygiene and grooming that include-- ·(A) Bed bath ·(B) Sponge, tub, and shower bath ·(C) Shampoo, sink, tub, and bed ·(D) Nail and skin care ·(E) Oral hygiene ·(F) Toileting and elimination The other subject areas in this section may be evaluated through written examination, oral examination or after observation of a Hospice Aide with a patient. Personnel #10: The personnel record did not have proof that the following were performed with a patient or pseudo patient: Tub bath, shower, use of bedpan, transfers from chair to stand, and use of a cane. The record listed that the method of orientation was verbal.

Upon patient record review, 2 of 5 (Patient #2 and #3) 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 #2: This patient had a cane. This was not included on plan of care. Patient #3: This patient had a shower chair. This was not included on plan of care.