Every finding on record at Home Connect Hospice LLC

Upon patient record review 8 of 19 (Patient #1,3,4,5,6,7,8,12) did not have evidence in the patient record that the hospice interdisciplinary group, in consultation with the individual's attending physician (if any), completed the comprehensive assessment no later than 5 calendar days after the election of hospice care. Patient#1: The record indicates patient admitted 1/17/24 and initial spiritual assessment completed on 1/24. There is no evidence of a spiritual assessment made within 5 days of admission. Patient#3: The record indicates patient admitted 11/19/24 and initial spiritual assessment completed on 11/25. There is no evidence of a spiritual assessment made within 5 days of admission. Patient#4: The record indicates patient admitted 2/23/24 and initial spiritual assessment completed on 2/29. There is no evidence of a spiritual assessment made within 5 days of admission. Patient#5: The record indicates patient admitted 1/2/25 and initial spiritual assessment completed on 1/10. There is no evidence of a spiritual assessment made within 5 days of admission. Patient#6: The record indicates patient admitted 9/19/24 and initial spiritual assessment completed on 9/25. The initial psycho social assessment completed on 10/26. There is no evidence of a initial assessments made within 5 days of admission. Patient#7: The record indicates patient admitted 1/2/25 and initial spiritual assessment completed on 1/9. There is no evidence of a spiritual assessment made within 5 days of admission. Patient#8: The record indicates patient admitted 8/6/24 and initial spiritual assessment completed on 8/23. There is no evidence of a spiritual assessment made within 5 days of admission. Patient#12: The record indicates patient admitted 10/19/24 and initial spiritual assessment and psychosocial assessment completed on 1/26. There is no evidence of a initial assessments made within 5 days of admission.

Upon patient record review, 3 of 19 (Patient #1,4,8) did not have evidence in the patient record that a review was completed of all prescription and non-prescription medications, including herbal remedies that could affect drug therapy. This review includes, but is not limited to: • Effectiveness of drug therapy • Drug side effects • Actual or potential drug interactions • Duplicate drug therapy • Drug therapy currently associated with laboratory monitoring Patient#1: The medication profile indicates Polyethylene Glycol 3350 1 Packet ORAL 1 times a day for Constipation (17 GM Packet). There is no indication that there is instructions for mixing. Corrected on site. Patient#4: The medication profile indicates Triamcinolone Acetonide 0.1 % apply BID to body. There is no evidence of a specified area of application. Corrected on site. Patient#8: The medication profile indicates lidocaine patch 4% and for MiraLAX powder PRN for constipation. There is no evidence of application instructions for lidocaine patch. There is no evidence of mixing instructions for MiraLAX. Corrected on site.

Upon patient record review, 2 of 19 (Patient #2,11) did not have evidence in the patient record that the comprehensive assessment includes a bereavement component which includes the needs of the patient's family and other individuals focusing on the social, spiritual, and cultural factors that may impact their ability to cope with the patient's death. Information gathered from the initial bereavement assessment is incorporated into the plan of care and is considered in the bereavement plan of care. Patient#2: There is evidence of initial bereavement assessment completed on 1/17/25. However, there is no primary bereaved identified. Corrected on site. Patient#11: There is evidence of initial bereavement assessment completed on 8/22/24. However, there is no primary bereaved identified. Corrected on site.

Upon patient record review, 5 of 19 (Patient #1,4,5,11,13) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient#1: The record indicates that patient requires education and care for constipation, incontinence of bowel and bladder, pain and spiritual needs. There is no evidence of goals or interventions on plan of care regarding these patient needs. Corrected on site. Patient#4: The record indicates that patient requires education, Triamcinolone Acetonide 0.1 %, and care for skin itching . There is no evidence of goals or interventions on plan of care regarding these patient needs. Corrected on site. Patient#5: The record indicates that patient requires education and care for puree diet, foley care, respiratory issues for inhaler use, and diabetic management as patient is on insulin. There is no evidence of goals or interventions on plan of care regarding these patient needs. Corrected on site. Patient#11: The record indicate patient was admitted for terminal diagnosis of end stage renal disease. There is no evidence of goals or interventions related to these needs. Corrected on site. Patient#13: The record indicate patient was admitted for terminal diagnosis of cerebral atherosclerosis. There is no evidence of goals or interventions related to these needs. Corrected on site.

Upon patient record review, 3 of 19 (Patient #1,#4,#8) did not have evidence the plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions, including medications and treatments. Patient#1: The record indicates an order for Polyethylene Glycol 3350 1 Packet ORAL 1 times a day for Constipation (17 GM Packet). There is no indication that there in instructions for dilutant. Corrected on site. Patient#4: The record indicates an order for Triamcinolone Acetonide 0.1 % apply BID to body. There is no evidence of a specified area of application. Corrected on site. Patient#8: The record indicates an order for lidocaine patch 4% and for MiraLAX powder PRN for constipation. There is no evidence of application instructions for lidocaine patch. There is no evidence for dilutant instructions for MiraLAX. Corrected on site.

Upon patient record review, 1 of 19 (Patient#7) did not have evidence that a revised plan of care includes information from the patient's updated comprehensive assessment and must note the patient's progress towards outcome/goals from the plan of care. Patient#7: The record indicates on 1/8/25 patient discussed with hospice team that he has decided to implement option for end of life act. Documentation indicates social worker has been coordinating with the doctor of patient's choice to assess and move forward with plan. There is no evidence of updated plan of care to incorporate the coordination of care for these needs. Corrected on site.

Upon client record review, 2 of 19 (Patient #7,8) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient#7: The record indicates the social worker frequency is ordered at 1 time per month. There is evidence that the social worker visited 5 times in January on 1/6,1/9,1/13,1/14,and 1/17/25. The record also indicates the nurse frequency is ordered at 2 times per week. There is evidence that only one visit was made the week of 1/8 and 1/15/25. Corrected on site with updated orders. Patient#8: The record indicates the social worker frequency is ordered at 1 time per month. There is evidence the social worker completed visits on 10/12 and 10/28/24. Corrected on site with updated frequency order.

Upon patient record review 1 of 19 (Patient #7) did not have evidence that the IDG ensures that the care and services provided are based on all assessments of the patient and family needs. Patient#7: The record indicated on 1/13 and 1/15/25 patient family requested silver nitrate swabs for nose bleeds. There is no evidence of follow-up. Corrected on site with late entry documentation.

Upon patient record review 6 of 19 (Patient #1,3,4,6,9,12) 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#1: The record indicates aide frequency is ordered at 2 times a week. The week of 1/14 visits were made 1/14, 1/15, and 1/16/25. There is no evidence of aide visits or missed visits documented during the week of 11/24/24-11/30/24. The visit on 1/15 was voided as aide indicated it was documented in error. Visits from week of 11/24 were entered as late documentation. Corrected on site. Patient#3: The record indicates aide frequency is ordered at 3 times a week. There is evidence of 4 visits documented the week of 1/14 on 1/14, 1/15,1/16,1/17/25. The week of 1/6 there is only evidence of one visit on 1/7. The week of 12/1/24 there is evidence of only 2 visits documented on 12/3 and 12/6/24. Corrected on site. Week of 1/14/25 one visit was entered in error and was voided. Late documentation was entered for other visits. Patient#4: The record indicates the aide frequency is ordered at 2 times per week. There was only evidence of one visit documented for the weeks of 3/27/24, 4/18/24, and 4/24/24. Corrected on site with late documentation entry. Patient#6: The Plan of Care indicates partial shower to be given by aide. Aide visit on 1/8 and 1/15/25 noted she gave full shower. Patient#9: The Plan of Care indicates patient bedbound and to receive a complete bed bath. On 1/10 and 1/14/25 aide visit the aide documents giving a shower per patient request. Patient#12: The record indicates a frequency for aide visits at 3 times per week. There is no evidence of completed aide visits after 12/31/24. Corrected on site with late documentation entry.

Upon observation, there was no evidence the annual report documents the use of volunteers providing day to day administrative and/or direct patient care services in an amount that, at a minimum, equals 5 percent of the total patient care hours of all paid hospice employees and contract personnel. There is evidence of a report that indicates use of volunteers equals 2% of the total patient care hours.

Upon patient record review, 1 of 5 (Patient #3) did not have evidence the plan of care must includes all services necessary for the palliation and management of the terminal illness and related conditions, including a detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs. Patient #3: 11/16/21 Order for Chaplain Visit 1-2x/month, as requested by patient. Per patient request is not in compliance as a stand alone frequency.