Every finding on record at Med Care Hospice Inc

Based on interview and record review, the agency failed to ensure covered services were available on a 24-hour basis when reasonable and necessary to meet the needs of the patient and family. Specifically, the agency failed to have a reliable method for patients and families to contact staff for assistance, as the posted phone contact number routed to a fax line; the agency did not have a chaplain to provide bereavement services or a social worker to provide psychosocial services; and the agency did not have administrative staff available during operational hours. --- Findings include:1. On 1/8/26 at 4:36 p.m., the surveyor attempted to enter the agency and no staff were available. The surveyor called the phone number posted on the door, which connected to a fax number, and was unable to contact the agency.On 1/8/26 at 9:40 a.m., the anonymous complainant stated staff did not meet patient needs, including failure to provide a 24/7 response to care needs, and reported inadequate administrative oversight.On 1/8/26 at 5:09 p.m., the surveyor interviewed a home health aide/certified nurse aide (HHA/CNA) who arrived at the office and stated she was unable to assist with requests to conduct the survey. She reported she was the only staff member ever present in the office and that the administrator had not been in the office since the beginning of October 2025. She further reported the alternate administrator was rarely in the office.On 1/12/26 at 11:10 a.m., during the entrance interview, the administrator reported the agency did not have a chaplain or social worker hired and had not contracted for these services.2. Review of Patient #1’s record revealed Patient #1 was the only active patient, with a start of care date of 10/15/25 and a terminal diagnosis of heart failure, requiring registered nurse (RN) visits once weekly for disease and medication management and HHA/CNA services twice weekly for assistance with activities of daily living (ADLs).Review of the plan of care (POC) for Patient #1 revealed interventions reflecting the need for bereavement and psychosocial services, which were not provided due to the agency not having a chaplain or social worker available to provide these services.On 1/21/26 at 9:55 a.m., the surveyor called Patient #1 and left a voicemail attempting to confirm the patient was receiving services. No return call was received from Patient #1 by the end of the survey on 1/22/26.On 1/20/26 at 3:20 p.m., the surveyor interviewed the administrator, who reported he hired a chaplain and social worker on 1/20/26. The agency did not have required core services available to Patient #1 from admission on 10/15/25 through 1/20/26.On 1/12/26 at 11:10 a.m., during the entrance interview, when the survey team informed the administrator that the contact phone number posted on the agency door routed to a fax number, preventing patients and the public from reaching agency staff, the administrator stated he believed it was an accident and shrugged and waved both hands. Attempts were made to redirect the discussion; however, the administrator moved on to other topics.

Based on interview and record review, the hospice failed to ensure clinical records were readily available upon request by the State Agency (SA) surveyors. --- Findings include: Clinical records for current and discharged patients were requested from the Administrator on 1/12/26 at 11:10 a.m. 2. On 1/14/26 at 11:43 a.m. the SA surveyor again requested complete records of all discharged patients. In an electronic mail (email) response, the Administrator stated he had provided all requested information. However, the record failed to show discharge summaries for Patient's #2, #3, #4 and #5. Clinical record review showed a communication note indicating Patient #2 was discharged from the hospice on 3/17/25 "due to transferring to another hospice." The clinical record failed to show any documentation of a discharge summary Similar findings of the records failing to have a completed discharge summary was found with Patient's #3, #4 and #5. 3. On 1/15/26 at 10:48 a.m., the discharge summaries for Patient's #2, #3, #4 and #5 were again requested from the Administrator and in an email response, the Administrator stated he had already provided the requested information to surveyors. No discharge summaries for Patient's #2, #3, #4 or #5 were ever available for review by SA surveyors.

Upon patient record review, 2 of 3 (Patient 2 and 3) did not have evidence in the patient record that a review was completed of all prescription and non-prescription medications, including herbal remedies that could affect drug therapy. This review includes, but is not limited to: • Effectiveness of drug therapy • Drug side effects • Actual or potential drug interactions • Duplicate drug therapy • Drug therapy currently associated with laboratory monitoring Patient 2. Home visit medication reconciliation revealed the patient was prescribed Lisinopril 20 mg oral daily, Ibuprofen 200 mg 1 tab oral as needed (PRN), Potassium Chloride 99 mg 1 tab oral every evening, and Magnesium 400 mg 1 tab oral every evening. The medications were not listed on the medication profile. Patient 3. Home visit medication reconciliation revealed the patient was prescribed Aspirin 81 mg Enteric Coated 1 tab oral daily. The medication was not on the medication profile.