Every finding on record at Homestead Home Health & Hospice LLC

Upon patient record review, 1 of 14 (Patient #3) did not have evidence that the patient chooses a health care provider, including an attending physician. Patient #3: The Hospice Medicare Election statement does not clearly identify the patient’s choice for the attending physician nor does it clearly indicate the patient chooses the hospice Medical Director as their attending. The line to write in the attending physician is left blank. Addendum to choose an attending physician was added on 8/17/23. Corrected on Site.

Upon patient record review, 1 of 14 (Patient #12) 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 #12: The initial Bereavement Risk Assessment was not completed to date.

Upon patient record review, 1 of 14 (Patient #4) 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 equipment and supply needs. Patient #4: The record reflected that this patient had oxygen orders. The oxygen concentrator or O2 Tank were not included on the Plan of Care.

Upon personnel record review, 1 of 13 (Personnel #13) did not have evidence that a skills competency assessment, specific to each discipline had been conducted for all personnel including volunteers initially during orientation. Personnel #13: The volunteer had provided a self assessment only on Competency Skills document. The Volunteer Coordinator did not initial/date skills validated in space provided on form.

Upon patient client record review, 2 of 14 (Patients #3 and 14) did not have evidence that each patient record contains: • Signed copies of the notice of patient rights in accordance with 418.52 • Signed election statement in accordance with 418.24 Patient #3: The Hospice Medicare Election statement does not clearly identify the patient’s choice for the attending physician nor does it clearly indicate the patient chooses the hospice Medical Director as their attending. The line to write in the attending physician is left blank. Addendum to choose an attending physician was added on 8/17/23. Corrected on Site. Patient #14: The Notification of Hospice Non-Covered Items, Services and Drugs to not elect was checked. However, the space provided was not initialed by beneficiary.

Upon patient client record review, 2 of 14 (Patients #11 and 12) 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. Electronic signatures are acceptable as long the hospice is following appropriate safeguards to prevent unauthorized access to the patient records. Patient #11: Physician admitting order was not dated by referring physician. Patient #12: Physician admitting order was not dated by referring physician.