Every finding on record at Heart of Hospice, LLC

Based on record review and interview, the hospice failed to ensure an individualized plan of care was fully developed to include all services necessary for the palliation and management of the terminal illness for nineteen (Patients #1, 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14 and 16) of 19 patients reviewed. --- Patient #1 A plan of care dated 04/01/24 to 05/30/24 documented a primary diagnosis of chronic obstructive pulmonary disease and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #2 A review of the plan of care dated 02/29/24 to 04/28/24 documented a primary diagnosis of prostate cancer and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #3 A plan of care dated 03/09/24 to 05/07/24 documented a primary diagnosis of senile degeneration of the brain and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #4 A plan of care dated 04/04/24 to 06/02/24 documented a primary diagnosis of Alzheimer's disease and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #5 A plan of care dated 04/01/24 to 06/29/24 documented a primary diagnosis of cancer of unspecified bronchus or lung and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #6 A plan of care dated 02/29/24 to 05/28/24 documented a primary diagnosis of cancer of the right breast and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #7 A plan of care dated 04/19/24 to 06/17/24 documented a primary diagnosis of Parkinson's disease and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #8 A plan of care dated 05/03/24 to 07/31/24 documented a primary diagnosis of osteomyelitis and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #9 A plan of care dated 03/23/24 to 06/20/24 documented a primary diagnosis of cancer of cervix and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #11 A plan of care dated 05/18/24 to 08/15/24 documented a primary diagnosis of Parkinson's and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #12 A plan of care dated 04/12/24 to 07/10/24 documented a primary diagnosis of lobular cancer of left breast and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #13 A plan of care dated 03/25/24 to 05/23/24 documented a primary diagnosis of congestive heart failure and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #14 A plan of care dated 01/11/24 to 04/09/24 documented a primary diagnosis of heart failure and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #16 A plan of care dated 04/13/24 to 06/11/24 documented a primary diagnosis of hypertensive heart disease with heart failure and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. On 05/29/24 at 2:04 pm, Staff A stated the plans of care for Patients #1, 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14 and 16 failed to include individualized services necessary for the palliation and management of the terminal illness.

Based on record review and interview, the hospice failed to ensure the plan of care was revised to reflect the development of wounds for one (Patient #3) of 19 patients. --- Patient #3 A review of the plan of care dated 03/09/24 to 05/07/24 and plan of care updates dated 03/13/24, 03/27/24, 04/10/24 and 04/24/24 showed no interventions or goals developed in relation to the development of a pressure ulcer. A review of the clinical record showed a physician's order for treatment to be provided to a stage II pressure ulcer to the left iliac crest. Skilled nurse notes dated 03/21/24 03/28/24, 04/11/24, 04/18/24, 04/25/24 and 05/02/24 documented the presence of a stage II pressure ulcer to the left iliac crest. On 05/29/24 at 2:20 pm., Staff A stated the plan of care for Patient #3 was not updated to reflect the presence of a stage II pressure ulcer.

Based on record review and interview, the hospice failed to the ensure plans of care was coordinated with the long-term care facility for three (Patients #11,13 and 14) of 19 patients reviewed. --- Patient #11 A plan of care dated 05/18/24 to 08/15/24 documented a primary diagnosis of Parkinson's and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #13 A plan of care dated 03/25/24 to 05/23/24 documented a primary diagnosis of congestive heart failure and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. Patient #14 A plan of care dated 01/11/24 to 04/09/24 documented a primary diagnosis of heart failure and showed no individualized plan of care development for the services necessary for the palliation and management of the terminal illness. On 05/29/24 at 2:30 pm, Staff A stated the plan of care for Patients #11, 13 and 14 did not outline the patient specific interventions to be to be provided by the nursing home or the hospice for the palliation and management of the terminal illness.