Every finding on record at Hospice Services of Nevada Inc.

Observed in Record Review. During review of Bereavement records and confirmed by the DON. A post death bereavement assessment had not been completed. Organization had stated that the initial assessment had been reviewed with the primary caregiver and discussed for any updates, but it had not been documented within the record. During review of 2 of 2 Bereavement records and confirmed by the DON. The bereavement plan of care had not been completed or updated to reflect the needs of the bereaved to include the type of bereavement services to be offered based on a post death assessment. Example; During review of HOSbr#1 and HOSbr#2 the post death assessment had been blank and not completed.

Observed in Record Review. During review of 2 of 2 Bereavement records and confirmed by the DON and the bereavement Coordinator. The bereavement plan of care had not been completed or updated to reflect the needs of the bereaved to include the type of bereavement services to be offered based on the post death assessment. Example: During review of HOSbr#2 the plan had been incomplete to include information of a family member that had been identified as grieving along with the primary caregiver. The plan had stated that both the son and daughter of the deceased may need extra support, however the plan had not specified what that would be and how often.

Observed in Record Review. In 3 of 7 patient records reviewed, Confirmed by the DON, The HHA plan of care had not been updated to reflect changes and care required to the patient. Example: During review of HOS rr #3 The HHA plan of care had not documented that the patient had eczema and where. During review of HOS v#1 The plan had not been updated since 2023 and had not identified the patient skin tear on the lower extremity. During review of HOSv#2 the plan of care had not specified instruction to the HHA if the oxygen ordered for continuous use could be removed during bathing..

Observed in Individual Tracer. In 9 of 11 patient records reviewed, Confirmed by the DON. During review of Hospice patient records, the updated comprehensive assessment had not included the patient's progression to goals. Example: During review of HOSv#1,v#2,v#3,rr#1,rr#2 the updated plan of care had maintained the initial goals and outcomes to include the initial target date and had not updated nor documented progression to the goals.

Observed in Individual Tracer. In 11 of 11 patient records reviewed, Confirmed by the DON. The plan of care goals and interventions had not been based on problems identified during the initial, comprehensive and updated assessment. Example; During review of HOSv#1, HOSv#2, HOSv#3 HOSrr#1 the goals had been similar and had been based on potential needs and not the patient assessment. Example: A goal for all patients had stated that there may be a potential for increased anxiety or agitation due to the disease process. All goals had a target date for the end of certification. Example: During review of HOSv#1 the MSW had assessed the need to assist family to determine funeral arrangements. During discussion with MSW, it had been determined that he had been encouraging daughter to identify a funeral home, however she had been reluctant. The patient plan of care had not identified the problem , intervention, or goal as assessed by the MSW.

Observed in Individual Tracer. In 9 of 11 patient records reviewed, Confirmed by the DON. The plan of care had not been updated the plan of care. Example: During review of HOSv#1 the plan of care established with a target date for all goals had been the end of April 2022. Documentation of the plan of care remained the same as of survey date June 2022. This was also observed in records HOSv#2, HOSv#3, HOSrr#1,#2,#3.