Every finding on record at Golden Sky Hospice, Inc.

Upon patient record review, 2 of 3 applicable (Patients #2 and #3) did not have evidence in the patient record that the hospice aide assignments and duties were: • Assigned to a specific patient by a registered nurse that is a member of the interdisciplinary group • Written patient care instructions for a hospice aide must be prepared by a Registered Nurse who is responsible for the supervision of a hospice aide as specified under paragraph (h) of 418.76 • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. The use of “PRN” or “per patient choice”, for any task, whether personal care or non-personal care tasks, are not acceptable Patient #2: Review of a communication log dated 1/17/2022 documented that the primary caregiver called and verbalized ..."pcg requested Covid test due to had visitors last week and now he has had a change in his condition with coughing, wheezing, gasping for air, can hardly breath and O2 sats are dropping..." and patient noted to be using his Oxygen on PRN basis. There was no documentation to indicate the Aide Care Plan was updated with the potential of Infection precautions and oxygen precautions. Patient #3: Review of the Aide Care Plan dated 2/1/2022, documented instructions which included for the Aide to give a shower 3x week. During a Surveyor conducted home visit, the daughter of the patient stated that the patient was no longer to get in the shower, due to weakness and pain. On 2/1/2022, the RN documented ..."Patient mainly sits, noted with difficulty standing due to BLE weakness and stiffness on both knees"... and on 2/22/2022, the RN documented the patient was "chair bound". The Aide Care Plan was not updated to reflect the changes in the patient's condition and to change from shower to a bed bath.