Every finding on record at Monument Healthcare Inc

Based on record review and interview, the agency failed to ensure services were furnished in accordance with the individualized written plan of care for two of four patients (Patients #2 and #3) whose clinical records were reviewed. This failure could place the patients at risk of not having their needs met. The findings included: A. Review of Patient #2's Hospice IDG Comprehensive Assessment and Plan of Care Update report dated 07/05/22 revealed a start of care date of 03/18/22 and a terminal diagnosis of Malnutrition Marasmus (severe form of malnutrition, specifically, protein-energy under nutrition). Review of the recertification plan of care for 06/16/22 to 09/13/22 revealed orders for the hospice aide to visit once a week for one week followed by three times a week for twelve weeks. Review of the physician order dated 07/06/22 revealed orders for the hospice aide to visit three times a week for ten weeks. Review of the hospice aide notes and the Client Calendar Report revealed two visits the week of 07/10/22 through 07/16/22, one visit the week of 07/17/22 through 07/23/22, and one week the week of 07/24/22 through 07/30/22. During an interview and record review on 08/10/22 at 12:45 p.m., the findings above were reviewed and discussed with the Supervising Nurse. The Supervising Nurse verified the findings and stated she did not know why there were missing visits and that she she would ask the hospice aide if there are outstanding notes. The Supervising Nurse stated that the potential client negative outcome could be the measures no met, stress on the client and caregiver, and a negative experience in the quality of life. B. Closed record of Patient #3's Hospice IDG Comprehensive Assessment and Plan of Care Update report dated 05/10/22 revealed a start of care date of 09/12/19 and a terminal diagnosis of Cerebrovascular Disease. Review of the recertification plan of care for 05/08/22 to 07/06/22 revealed orders for the hospice aide to visit twice a week for eight weeks followed by once a week for one week. Review of the hospice aide notes and the Client Calendar Report revealed one hospice aide visit the week of 05/29/22 through 06/04/22. During an interview and record review on 08/10/22 at 12:58 p.m., the findings above were reviewed and discussed with the Supervising Nurse. The Supervising Nurse verified the findings and stated she did not know why only one hospice aide visits was made that week. The Supervising Nurse stated that the potential client negative outcome could be that the client would not get the care needed and stress on the client and caregiver. C. Review of the agency's policy titled "Interdisciplinary Group Coordination of Care" revised April 2019 revealed in part, "...11. Continuity of care will be maintained throughout the patient's course with hospice..."