Every finding on record at Helping Hand Hospice

Upon patient record review, 5 of 12 (Patients # 2, 3, 7, 9, 10) did not have evidence in the patient record that hospice aide assignments and duties are: • 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: Upon review of patients Hospice Aide POC dated 02/27/2025, the aide duties of "record bowel movement" and "change linens" did not contain a frequency. Patient # 3: Upon review of patients Hospice Aide POC dated 10/08/2025, the aide duties of "record bowel movement" and "change linens" did not contain a frequency. Patient # 7: Upon review of patients Hospice Aide POC dated 03/12/2025, the aide duties of "record bowel movement" and "change linens" did not contain a frequency. Patient # 9: Upon review of patients Hospice Aide POC dated 03/22/2025, the aide duties of "record bowel movement" and "change linens" did not contain a frequency. Patient # 10: Upon review of patients Hospice Aide POC dated 12/27/2025, the aide duties of "record bowel movement" and "change linens" did not contain a frequency.

Upon patient record review 2 of 12 (Patients # 7, 10) 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 #7 Upon review of medical record, the patient's aide POC had orders to record bowel movements. The aide notes did not contain a recording of bowel movement dates entered on 3/19, 3/22, 3/25, and 3/27/25. Patient #10 Upon review of medical record, the patient's aide POC had orders to record bowel movements. The aide notes did not contain a recording of bowel movement dates entered on 3/6, 3/10, 3/13, 3/17, 3/20, 3/24, 3/27, 3/31/2025.

Upon patient record review 1 of 12 (Patient # 3) did not have evidence documentation in the patient record that a Registered Nurse made an on-site visit to the patient's home no less frequently than every 14 days to assess the quality of care and services provided by the hospice aide and to ensure that services ordered by the hospice interdisciplinary group meet the patient's needs. Patient # 3 Upon review of patient chart, POC contained orders for aide twice per week. The record did not contain evidence that aide supervisory visits by RN where made every 14 days. RN Supervisory visits were made 12/18/24 to follow on 1/04/25.

Upon personnel record review, 1 of 12 (Personnel # 9) did not have evidence the hospice employees and contract employees have received orientation on the hospice philosophy. Personnel # 9 Upon review of the personnel file did not contain the following required orientation topic, hospice philosophy.

Upon patient client record review, 1 of 5 (Patient #2) did not have evidence that all entries are legible, clear, complete, and appropriately authenticated and dated in accordance with the organizations policies and procedures and currently accepted standards of practice. Patient #2 Nursing narrative indicated the phone number for a different accrediting organization was provided to the client. The ACHC number was not provided.