Every finding on record at Hospice Advantage, LLC

It is required that each patient’s individualized written plan of care: reflects patient and family goals; and identifies planned interventions based on problems identified in the initial and updated comprehensive assessments. This standard was not met as evidenced by clinical record review and interview. In 2 of 14 (14%) clinical records reviewed, the agency did not ensure that all planned interventions based on problems identified in the initial and updated comprehensive assessments were included in the patient's individualized written plan of care. CLINICAL RECORD 5: The patient elected the hospice benefit on 04/08/2025. A physician's order dated 04/17/2025 ordered "Clopidogrel (antiplatelet) 75mg tablet daily." The plans of care dated 04/08/2025 through 07/06/2025 and 07/07/2025 through 10/04/2025 did not document an intervention related to the patient's increased risk of bleeding. CLINICAL RECORD 8: The patient elected the hospice benefit on 06/05/2025. The initial nursing assessment dated 06/05/2025 documented "Patient is incontinent." The plans of care dated 06/05/2025 through 09/02/2025 and 09/03/2025 through 12/01/2025 did not document a planned intervention related to skin integrity based on the patient's identified problem with incontinence. During interviews and joint record reviews on 09/04/2025, the Area Executive of Clinical Operations confirmed that bleeding risk and skin integrity interventions were not included in the patients' plans of care.

It is required that hospice aides are assigned to a specific patient by a registered nurse who is a member of the Interdisciplinary Group. Written patient care instructions for a Hospice Aide are prepared by a RN who is responsible for the supervision of the Hospice Aide. This standard was not met as evidenced by clinical record review and interview. In 1 of 12 (8%) clinical records reviewed of patients who received Hospice Aide (HA) services, the agency did not ensure that all written patient care instructions were included in the Hospice Aide care plan. CLINICAL RECORD 1: The patient elected the hospice benefit on 04/30/2025 with a diagnosis of congestive heart failure. A physician's order dated 08/22/2025 ordered a wound dressing for the patient's coccyx wound. The plan of care, dated 07/29/2025 through 10/26/2025, ordered "HA 2 times per week." The Hospice Aide care plan dated 08/13/2025 assigned the HA the relevant task: "Bed Bath every visit." The HA care plan was not updated to include specific instructions for the HA on how to proceed if the wound dressing on the patient's coccyx became wet or dislodged during a bed bath. During a joint record review on 09/04/2025, the Area Executive of Clinical Operations confirmed that the wound dressing instructions were not included in the Hospice Aide care plan.