Every finding on record at Hospice of Dickinson County

Based on review of the Emergency Preparedness Plan (EPP) and interview, the facility failed to maintain a current list of names and contact information for the patients physicians in the EPP Communication Plan. This failure had the potential to affect patients who received care from the hospice and could delay the hospice's ability to respond to an emergency. --- Findings Include: Review of the hospice EPP Communication Plan showed the plan did not include a list of patients' physicians and their contact information. During an interview on 01/29/25 at 5:53 PM Staff A, Hospice Director, stated, "The patients physicians are in our on-call book, but not in the emergency plan."

Based on record review, policy review, and interview, the Hospice Agency (HA) failed to ensure the comprehensive assessment was completed by the Social Worker within five days of the election of Hospice benefit for 2 (Patient 5 and 11) of 14 patients reviewed. This failure had the potential to delay medically needed social services and service provision to hospice patients. --- Findings Include: Review of hospice policy titled, "Medical Social Services," revised June 2019, showed, "Procedure 1. The Social Worker's services are provided in accordance with the IDG (Interdisciplinary Group) plan of care. . . and 2. The purpose of the psychosocial assessment is to help the IDG identify issues that either impede or facilitate the patient's treatment and to assist the patient/family in reaching the maximum benefit from Hospice care and services. . . " Review of the same policy showed an attachment titled, ";IDG Team Initiation and Coordination Process 2023," revised 01/04/23, that showed, ";Initial Psychosocial & Complicated Grief Risk Assessment," and identified the, "MSW [Master of Social Work]" with a Timing/Due of, "5 days from admit or within a reasonable timeframe based off pt [patient]/PCG [patient care giver] availability." Patient 5 Review of Patient 5's record titled, "Patient Information," showed the date of hospice election as 03/08/24 with medical diagnoses that included senile degeneration of the brain, hypertension, and arthritis. Review of Patient 5's record showed the initial psychosocial assessment was completed by the Social Worker (SW) on 03/15/24 (7 days after election of the Hospice benefit.) The record showed the SW made a phone call to the patient and/or family on 03/13/24 but made no notes regarding contact or a request for an assessment to be completed past the allotted five-day assessment completion period. During an interview on 01/29/25 at 2:30 PM, Staff B, Clinical Manager, confirmed the date of the Social Worker's assessment for Patient 5 was 03/15/24 and confirmed the record did not have documentation of earlier contact with the patient and/or family. Patient 11 Review of Patient 11's record titled, "Patient Information," showed the date of hospice election as 07/30/24 with medical diagnoses that included Parkinson's disease, hypertensive heart and chronic kidney disease with heart failure, and chronic kidney disease. Review of Patient 11's record showed the initial psychosocial assessment was completed by the SW on 08/14/24 (15 days after the date of hospice election.) The record showed the SW attempted a first contact phone call on 08/07/24 and documented, "Phone call to [family name] placed so I can meet with [patient] and family as well as complete Psychosocial Assessment – [family name] did not answer so a voicemail was left which [sic] social work direct line is provided in the voicemail," dated and signed on 08/09/24 at 8:37 AM. During an interview on 01/29/25 at 4:15 PM, Staff B, Clinical Manager, confirmed the SW initial assessment was dated 08/14/24 and confirmed there was no documentation of patient contact prior to 08/07/24 in the record.