Every finding on record at Generous Hospice and Palliative Care Inc

Upon patient record review 1 of 8 (Patient #4) did not have evidence in the patient record that the comprehensive assessment identifies the physical, psychosocial, emotional, and spiritual needs related to the terminal illness that must be addressed in order to promote the hospice patient's well-being, comfort, and dignity throughout the dying process. Patient #4: On the initial assessment, the RN assessed needs for spiritual care. The Spiritual care entered a "visit" - however, the visit note was blank and did not provide a spiritual assessment. In the narrative the SC documented that the family did not want spiritual care, however, neither the SC or the RN provided an initial spiritual assessment within the first 5 days.

Upon patient record review, 2 of 8 (Patients #1, 3) 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 #1: The patient is prescribed Aspirin. There are no interventions or goals on the POC for use of anticoagulants or bleeding precautions. Patient #3: Patient has a diagnosis of GERD and aspiration precautions. There are no interventions or goals under the GI pathway to address this.

Upon personnel record review, 1 of 12 (Personnel #9) 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 #9: 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 observation, there was no evidence the annual report documents the use of volunteers providing day to day administrative and/or direct patient care services in an amount that, at a minimum, equals 5 percent of the total patient care hours of all paid hospice employees and contract personnel. The agency had not used Volunteers in 2024 or 2025 to date.

Upon patient record review, 1 of 5 (Patient #2) 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 During home visit it was observed the patient uses a cane for ambulation. The cane was not reflected in patient record as ordered or on POC.

Upon patient client record review, 5 of 5 (Patient #1, #2, #3, #4 and #5) 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 CTI benefit period duration does not have correct time periods for 1st and 2nd benefit periods. The start of care date was 11/27/21. The agency benefit period reads 11/27/21 to 2/25/22 and 2/26/22 to 4/26/22. The 1st benefit should read 11/27/21 to 2/24/22 (90 days) and the 2nd benefit period should read 2/25/22 to 5/25/22 (90 days). Patient # 2 The CTI benefit period duration does not have correct time periods for 1st and 2nd benefit periods. The start of care date was 12/4/21. The agency benefit period reads 12/4/21 to 3/2/22 and 3/3/22 to 5/1/22. The 1st benefit should read 12/4/21 to 3/3/22 (90 days) and the 2nd benefit period should read 3/4/22 to 6/1/22 (90 days). Patient # 3 The CTI benefit period duration does not have correct time periods for 1st and 2nd benefit periods. The start of care date was 12/4/21. The agency benefit period reads 12/4/21 to 3/2/22 and 3/3/22 to 5/1/22. The 1st benefit should read 12/4/21 to 3/3/22 (90 days) and the 2nd benefit period should read 3/4/22 to 6/1/22 (90 days). Patient # 4 The CTI benefit period duration does not have correct time periods for 1st benefit period. The start of care date was 11/20/21. The agency benefit period reads 11/20/21 to 2/18/22. The 1st benefit should read 11/20/21 to 2/17/22 (90 days). Patient # 5 The CTI benefit period duration does not have correct time periods for 1st benefit period. The start of care date was 11/27/21. The agency benefit period reads 11/27/21 to 2/25/22. The 1st benefit should read 11/27/21 to 2/24/22 (90 days).