Based on interview and review of the agency's Emergency Preparedness Plan (EPP), the facility failed to include how the agency would inform State and local officials of any on-duty staff or patients that they were unable to contact. This failure had the potential to affect the 27 patients receiving care from the above-named hospice agency and hindered the agency's ability to provide care and services during an emergency.Findings include: --- Review of the above-named hospice agency's EPP, revised 08/01/24, and provided by the facility, did not reveal information regarding how the facility would inform State and local officials of any on-duty staff or patients that they were unable to contact during an emergency.During an interview on 01/22/26 at 4:30 PM, the Director of Clinical Services (DCS) confirmed that he/she could not find documentation to address this notification under the communication portion of the EPP.
Every finding on record at Health at Home Hospice - Minnesota, LLC
Minneapolis, Minnesota · CCN 241593
2 findings across 1 survey, in the inspector's own words.
The inspector’s own words from form CMS-2567, unedited, including CMS’s own spacing. Names and some dates are redacted by CMS.
Survey of January 22, 2026
2 findingsBased on interview and a review of the agency Emergency Preparedness Plan (EPP), the agency failed to include a means, in the event of an evacuation, to release protected patient information and how this information would be shared with other providers, hospitals, or emergency personnel. This failure had the potential to affect the 27 patients receiving care from the above-named hospice agency and hinder the agency's ability to provide care and services during an emergency.Findings included: --- Review of the above-named hospice agency's EPP, revised 08/01/24 did not reveal information regarding how the agency would share protected health information with other entities or providers during an emergency.During an interview on 01/22/26 at 4:30 PM, the Director of Clinical Services (DOC) confirmed that he/she could not find documentation to address sharing of protected health information under the communication portion of the EPP.
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