Every finding on record at Jmdk Healthcare LLC

Upon patient record review, 4 of 14 (Patient #2,#3,#4,#6) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient 2:Upon admission, the patient's medical record includes documentation by the nurse of oxygen in use at 2 liters per minute via nasal cannula as needed. There is no evidence of problems, goals and interventions on the plan of care related to oxygen therapy. Patient 3:Upon admission, the medical record includes documentation by the nurse of assessment and training related to patient's ostomy. There is no evidence of problems, goals and interventions on the plan of care related to ostomy management. Corrected on site. Patient 4:Upon admission the medical record includes documentation by the nurse of patient being at high risk for aspiration. There is no evidence of problems, goals and interventions on the plan of care related to aspiration. Corrected on site. Patient 6:Upon admission, the medical record includes documentation of oxygen in use at 2 liters per minute via nasal cannula as needed. There is no evidence of problems, goals and interventions on the plan of care related to oxygen therapy. Corrected on site.

Upon patient record review, 2 of 14 (Patient #2,#3) did not have evidence the plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions, including equipment and supply needs. Patient 2:The medical record contained nursing documentation upon admission identifying use of walker, shower chair and hospital bed. There is no evidence that the walker, shower chair and hospital bed are included in the plan of care. Corrected on site. Patient 3: The medical record contained nursing documentation upon admission identifying use of walker, hospital bed, nebulizer, oxygen concentrator, oxygen supplies and ostomy supplies. There is no evidence that the walker, hospital bed, nebulizer, oxygen concentrator, oxygen supplies and ostomy supplies are included in the plan of care. Corrected on site.

Upon patient record review, 1 of 14 (Patient #1) did not have evidence that the IDG documents the sharing of information between all disciplines providing care and services in all settings, whether the care and services are provided directly or under arrangement. Patient 1: The medical record contains documentation by the nurse on 7/25/2023 of a PRN visit for symptom management to include vomiting of coffee ground emesis. There is no evidence that the physician was notified of the patient change of condition.

Upon patient record review, 1 of 14 (Patient #7) did not have evidence in the patient record that hospice aide assignments and duties are: • Assigned to a specific patient by a registered nurse that is a member of the interdisciplinary group • Written patient care instructions for a hospice aide must be prepared by a Registered Nurse who is responsible for the supervision of a hospice aide as specified under paragraph (h) of 418.76 • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. The use of “PRN” or “per patient choice”, for any task, whether personal care or non-personal care tasks, are not acceptable Patient 7: On admission, the medical record documentation identified the patient as a high risk for falls and the medication administration record included an entry of Eliquis for anticoagulation. There is no evidence that the aide plan of care includes fall risk and bleeding precautions. Corrected on site.

Upon patient record review 1 of 14 (Patient #1) did not have evidence documentation in the patient record that a Registered Nurse made an on-site visit to the patient's home no less frequently than every 14 days to assess the quality of care and services provided by the hospice aide and to ensure that services ordered by the hospice interdisciplinary group meet the patient's needs. Patient 1: The medical record includes an aide visit frequency of 2 visits per week effective 7/19/23. There is no evidence that supervisory visits were completed in the patient's home by a Registered Nurse no less frequently than every 14 days from 7/19/23 through 8/9/23.