Every finding on record at Hospice of Limestone County, Inc.

Based on medical record (MR) review, Alabama Board of Nursing Administrative Code, agency policy and procedure, and interview, it was determined the agency failed to ensure the nursing staff received the pronouncement of death via telecommunication with the physician as required by the Alabama Board of Nursing.This deficiency affected one of three Bereavement MRs reviewed and had the potential to negatively affect all patients admitted to the hospice.Findings include:Policy Number: 4-069.1Title: Provision of Care and Record ManagementRevision Date: NonePurpose: To establish the process to follow when a patient dies.Policy: …Individual state and community regulations and practices will be followed.Procedure:...5. The nurse will notify the Hospice Medical Director (MD) of the patient’s death as evidenced by reporting absence of vital signs and other signs of life. It will be the Hospice MD’s responsibility to pronounce death upon this notification.  Alabama Board of Nursing Administrative CodeChapter 610-X-6Standards of Nursing PracticeRevised: September 8, 2016610-X-6-.15   Telecommunication for Pronouncement of Patient DeathThe licensed nurse may receive pronouncement of a patient’s death from a physician via telecommunication. --- MR # 13 was admitted to the hospice agency on 6/24/24 with diagnoses including malignant neoplasm of unspecified part of left bronchus or lung, and essential hypertension. Review of the MR revealed a Skilled Nurse (SN) visit note dated 7/4/24. The SN documented the following in the Narrative Note, "...Son and daughter in law notified of patient passing. TOD (Time of Death) 1:50 PM. MD made aware."There was no documentation the SN received the pronouncement of death from the physician.An interview was conducted on 4/4/24 at 12:51 PM with Employee Identifier # 1, Assistant Director, who confirmed there was no documentation the physician made the death pronouncement.