Every finding on record at Miracle Healing Hospice, Inc.

Upon patient record review, 2 of 14 (Patient #9, 10) did not have evidence the plan of care must includes all services necessary for the palliation and management of the terminal illness and related conditions, including the following: • A detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs • The IDG demonstrates a proactive approach in developing each patient's plan of care by planning ahead for anticipated patient changes and needs. Decisions should reflect the patient/family preferences rather than be solely a response to a crisis. Patient #9: POC ordered MSW 1 PRN and at Recert. without a routine frequency. Patient #10: POC ordered MSW 1 PRN and at recert. without a routine frequency.

Upon client record review, 5 of 14 (Patient #6, 7, 9, 10, 12) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #6: POC ordered SN 1xw and RN every 2 weeks. RN made an extra weekly visit on 2/27. LVN also saw the patient this week. RN Previously saw the patient on 2/23. No evidence to support a change in frequency or PRN visit. Patient #7: POC ordered SN 1xw and RN every 2 weeks. RN made an extra visit the week of 2/11 on 2/11. LVN also saw the patient this week. RN Previously saw the patient on 2/6. No evidence to support a change in frequency or prn visit. Patient #9: POC ordered MSW 1 PRN and at Recert. MSW visits 10/6, 11/6, 12/6 and 1/6. No order for monthly; SC Monthly and 1 PRN – No evidence of a visit in March. Patient #10: POC ordered SN 1xw and RN every 2 weeks. RN made 2 visits the week of 10/22 on 10/23 and 10/26. LVN also saw the patient this week. No evidence to support an order for the extra visit or that the visits were PRN. RN made extra visit the week of 1/26 LVN also saw the patient this week. RN Previously saw the patient on 1/18. RN made extra visit the week of 3/24 on 3/26. LVN also saw the patient this week. RN previously saw the patient on 3/22. No evidence to support an order for the extra visit or that the visits were PRN. POC ordered MSW 1 PRN and at recert. MSW visits noted on 9/4, 11/3, 12/3, 2/5. No evidence of an order changing the frequency or any prn visits. Patient #12: POC ordered RN every 2 weeks and SN 1 per week. No evidence of an SN visit wk of 4/9. No evidence of an order changing the frequency or missed visit.