Every finding on record at Hcr, Inc

Based on record review and interview, the hospice failed to ensure completion of the initial spiritual assessment no later than 5 calendar days after the election of hospice care for two (Patients #8 and 14) of 19 patients. --- Findings:Patient #8A review of the clinical record showed an election of the hospice benefit on 01/08/25 with no completion of the initial bereavement and spiritual assessment from 01/08/25 to 01/14/25 (6 days after the election of the hospice benefit).  Documentation showed no patient or caregiver refusal of the initial bereavement risk assessment or initial spiritual assessment.Patient #14A review of the clinical record showed an election of the hospice benefit on 01/16/25 with no completion of the social worker assessment from 01/16/25 to 01/22/25 (6 days after the election of the hospice benefit), Documentation showed no patient or caregiver refusal of the initial bereavement risk assessment or initial spiritual assessment.On 05/15/25 at 1:00 pm., Staff A stated the initial comprehensive assessment was to be completed within five days of the election of the hospice benefit and the initial spiritual assessment for Patients #8 and 14 was not completed within the first five days of the election of the hospice benefit.

Based on record review and interview, the hospice failed to ensure volunteers provided services that equaled 5% of the total patient care hours of all paid hospice employees for 2024. --- Findings:A review of volunteer records and hours showed the hospice volunteers provided services that equaled 2.53% of the total patient care hours of all paid hospice employees for 2024. On 05/15/24 at 1:20 pm, Staff A stated the hospice volunteer services did not provide 5% of the total patient care hours of all paid hospice employees for 2024.

Based on record review and interview, the hospice failed to ensure imminence of death was assessed during the comprehensive assessment for three (Patients #5, 7 and 8 ) of eleven patients. Findings: Patient #5 A review of the Initial Assessment dated 02/15/22 showed no assessment of imminence of death. Patient #7 A review of the Initial Assessment dated 05/11/22 showed no assessment of imminence of death. Patient #8 A review of the Initial Assessment dated 04/25/22 showed no assessment of imminence of death. On 05/27/22 at 12:42 pm, Staff A stated imminence of death was not assessed on the comprehensive assessment for Patients #5, 7 and 8.

Based on record review and interview, the hospice failed to ensure the plan of care documented the frequency for skilled nurse visits for one (Patient #11) of 11 patients. Findings: Patient #1 A review of the plan of care dated 02/15/22 to 04/15/22 with plan of care updates dated 03/01/22, 03/16/22, 03/30/22 and 04/12/22 showed no skilled nurse frequencies ordered for visits made on 02/16/22, 02/18/22, 02/22/22, 02/23/22, 02/24/22, 02/25/22 03/02/22, 03/04/22, 03/05/22, 03/09/22, 03/11/22, 03/16/22, 03/17/22, 03/23/22,03/24/22, 03/25/22, 03/30/22, 04/01/22, 04/05/22, 04/06/22 and 04/08/22. On 02/27/22 at 12:10 pm, Staff A stated there were no documented skilled nurse frequencies from 02/15/22 to 04/15/22.

Based on record review and interview, the hospice failed to ensure hospice aide frequencies were provided within the scope of practice for seven (Patients #1, 3, 4, 5, 6, 8 and 11) of eleven patients. Findings: Patient #1 A review of the plan of care dated 03/17/22 to 05/15/22 showed a hospice aide frequency of three times a week and as needed. Patient #3 A review of the plan of care dated 03/21/22 to 05/19/22 showed a hospice aide frequency of two times a week and as needed. Patient #4 A review of the plan of care dated 01/17/22 to 04/16/22 showed a hospice aide frequency of three times a week and as needed. Patient #5 A review of the plan of care dated 02/15/22 to 05/15/22 showed a hospice aide frequency of three times a week and as needed. Patient #6 A review of the plan of care dated 03/14/22 to 05/12/22 showed a hospice aide frequency of as needed. Patient #8 A review of the plan of care dated 04/25/22 to 07/23/22 showed a hospice aide frequency of two times a week and as needed. Patient #11 A review of the plan of care dated 02/15/22 to 04/15/22 showed a hospice aide frequency of three times a week and as needed. On 05/27/22 at 12:00 pm, Staff A stated the hospice was not aware that as needed visits were an inappropriate frequency for the scope of practice of hospice aides.