Every finding on record at Juniper Point Healthcare, 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, document review and interview. In 2 of 2 (100%) clinical records reviewed in which a patient revoked/ or discharged to the community the election of hospice care, revealed the agency did not ensure that the patient's discharge summary was provided to the patient's attending physician. Document 1: The agency policy titled Discharge Summary Policy no. 1-026 (Revised November 2023) stated in part "A copy of the discharge summary will be provided to the patient's attending physician. If requested, the patient's clinical records will be provided." CLINICAL RECORD 13: The hospice benefit was elected on 05/10/2024, and the patient chose to revocate services on 09/02/2024. The clinical record review lacked evidence that a discharge summary was sent to the attending physician when the patient revoked from the hospice care. CLINICAL RECORD 14: The hospice benefit was elected on 09/09/2024, and the patient chose to revocate services on 01/17/2025. The clinical record review lacked evidence that a discharge summary was sent to the attending physician when the patient revoked from the hospice care. During an interview on 03/20/2025 with the Director of Clinical Services (personnel record #4), he stated that he was unaware that the discharge summary needed to be sent to the attending physician and stated he thought of discussing the discharge at the interdisciplinary group.

It is required that a hospice aide provides services ordered by the Interdisciplinary Group and included in the plan of care. This standard was not met as evidenced by record review and staff interview. 1 of 13 (8%) clinical records, in which the hospice aide services were accepted, revealed the agency did not ensure the hospice aide performed visits in accordance with the plan of care orders. Record #19446 (election of benefit: 01/29/22): The initial plan of care, effective 01/29/22, had orders written for the hospice aide to perform 3 visits per week. The aide documented the first visit was completed as of 2/02/2022, which was week two of the plan of care. There was no evidence of aide visits completed week one of the plan of care. In an interview with the Director of Nursing (#34211), conducted on 6/8/22, reported that she could not find any documentation for visits performed prior to 02/02/22, documentation for missed visit ,or order changes. Per Director of Nursing the calendar week was defined as Sunday through Saturday.