Every finding on record at Lotus Blossom Hospice and Palliative Care LLC

Upon patient record review, 1 of 19 (Patient #4) did not have evidence that the patient received information about the services covered under the hospice benefit. Patient #4: Records indicate evidence that Agency documentation stated under Medicare Hospice Non-Covered Item's addendum, pt/family request copy of all Hospice Non-Covered Services and items. Agency provided documentation stating, Physical Therapy, Occupational Therapy and Speech Therapy services are unrelated to Hospice Primary Diagnosis of Senile degeneration of brain upon Admission on 4/12/24 and will not be covered however, these non-core services are to be provided by the hospice.

Upon patient record review, 1 of 19 (Patient #12) 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 #12: Records indicate on Initial Plan of care that patient is a full code when there is evidence upon admission of patient Advanced Directive/POLST as a DNR on 12/19/23.

Upon patient record review, 1 of 19 (Patient #12) did not have evidence that the plan of care includes all services necessary for the palliation and management of the terminal illness and related conditions which including interventions to manage pain and symptoms. Patient #12: Records indicate RN documented patient had increased dyspnea, respirations and required changes to POC with no evidence of notifying MD for interventions or changes to Plan of care on 3/17/24.

Upon patient record review, 1 of 19 (Patient #1) 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 #1: Records indicate patient has oxygen however, there is no documentation of DME provided to patient on Recertification Plan of Care on 03/30/24.

Upon patient record review 1 of 19 (Patient #7) did not have evidence documentation in the patient record that a Registered Nurse following visit 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 #7: Records indicate RN Supervisory visit for Aide was greater than 14 days. Supervisory visit documented on 1/16/24 with following visit on 2/13/24.