Every finding on record at Gilbert's Hospice Care, LLC

Upon patient record review 1 of 19 (Patient #8) 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 8: Patient refused SC at the time of admit. No evidence of an initial spiritual assessment was completed. Assessment completed during survey.

Upon patient record review, 1 of 19 (Patient #2) 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 2: Risk for falls being documented on ongoing RN assessments. No evidence that risk for falls was added to the current plan of care. Corrected during survey.

Upon patient record review, 2 of 19 (Patient #8,10) 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 8: Patient was on oxygen at the start of care. No evidence that oxygen supplies was added to the current supply list/plan of care. Corrected during survey. Patient 10: Patient's wound care was discontinued on 04/22/2024. No evidence that wound care was removed from the current supply list. Corrected during survey.

Upon patient record review 1 of 19 (Patient #3) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient 3: Aide plan of care has linen changes ordered as once weekly. Aide documented that linens were changed twice weekly for the weeks of March 3rd, March 10th, and March 17th