Every finding on record at Hospice Care of South Carolina Low Country, LLC

It is required that if a patient revokes the election of hospice care or is discharged from hospice per hospice regulation §418.26 (i.e., no longer terminally ill), the hospice forwards to the patient’s attending physician a copy of the hospice discharge summary and the patient's record, if requested. This standard was not met as evidenced by clinical record review and interview. In 1 of 2 (50%) clinical records reviewed with patient revocation, the agency did not ensure the discharge summary was forwarded to the patient’s attending physician. CLINICAL RECORD 12: The patient elected the hospice benefit on 03/08/2024 and revoked the hospice benefit on 10/31/2024. There was no documented evidence in the clinical record that the discharge summary dated 10/31/2024 was forwarded to the patient’s attending physician. During a joint record review and interview on 08/06/2025, the Director of Operations/Registered Nurse (Personnel Record 1) confirmed that the record did not include documentation that the discharge summary was forwarded to the patient’s attending physician.

It is required that if the care of a patient is transferred to another Medicare/Medicaid-certified facility, the hospice must forward, to the receiving facility, a copy of the hospice discharge summary; and the patient's clinical record, if requested. This standard was not met as evidenced by a review of clinical records, document reviews and interviews. 1 of 3 (33%) records reviewed of pediatric patients hospitalized while on hospice services revealed the hospice did not provide patient information to the receiving facility. Clinical Record #4: was reviewed and identified the pediatric patient elected hospice care on 12/22/2021. The patient was hospitalized from 5/6/2022 to 5/26/2022 for respiratory failure and died on 5/26/2022 at the hospital. The coordination note dated 5/6/2022 documented the patient's father was transporting the patient to the local hospital. The coordination note dated 5/11/2022 documented the Registered Nurse (RN) communication with mother on patient status at hospital and to notify the nurse know when they returned home. The review of the clinical record revealed no documentation of hospice agency providing report or clinical information or documentation to the receiving hospital medical facility. The agency's policy #1-006 "Care/Service Coordination", stated in part, "care coordination will include, but not limited to... proper communication upon "hand off" of patient including the opportunity for questions between the giver and receiver of patient information... written evidence of care coordination may be found in the plan of care/services, discipline-specific notes in the patient's medical record or interdisciplinary group meeting notes. During an interview on 10/11/2022, the Director of Accreditation confirmed lack of documentation of coordination of care. A late entry was entered by RN on 10/12/2022.

It is required that when controlled medications are first ordered, a copy of the hospice’s written policies and procedures for the management and disposal of controlled medications is provided to the patient or family or patient’s legal representative(s). This standard was not met as evidenced by document reviews and interviews which revealed the agency did not provide a copy of its written policy on disposal of controlled substances in the pediatric admission packet or handbook. The sample pediatric admission packet included the handbook provided to the patient/family on admission titled, "Pediatric Hospice Resource Guide." The handbook was reviewed and revealed the section titled "Medication Safety," documented instruction and education on how to dispose of unused or expired medication by providing suggested methods of disposing medication from the Food and Drug Administration (FDA) or if medications can be safely flushed per the FDA's flush list. The agency's drug disposal policy was not documented in the handbook or provided in the sample admission packet. During an interview on 10/13/2022, the director of accreditation confirmed the hospice's drug disposal policy was not included in the pediatric handbook.