Every finding on record at Navitas Hospice Care Inc.

Upon patient record review 2 of 5 (Patient #4,5) did not have evidence in the patient record that the hospice interdisciplinary group, in consultation with the individual's attending physician (if any), completed the comprehensive assessment no later than 5 calendar days after the election of hospice care. Patient 4: Patient admitted 06/19/2024. There is no initial psychosocial assessment noted in patient’s medical record. On day 2 of survey, administrator presented surveyor with initial psychosocial assessment documentation dated 06/19/2024. Due to paper charting, surveyor unable to verify when this assessment was completed. Patient 5: Patient admitted 06/14/2024. There is no initial psychosocial assessment noted in patient’s medical record. On day 2 of survey, administrator presented surveyor with initial psychosocial assessment documentation dated 06/14/2024. Due to paper charting, surveyor unable to verify when this assessment was completed.

Upon patient record review, 2 of 5 (Patient #3,4) 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 3: Patient has an order for Plavix 75mg daily in the plan of care. There is no evidence of bleeding precautions in the plan of care. Patient 4: Patient has an order for aspirin 81mg daily in the plan of care. Aspirin is documented as an antiplatelet. There is no evidence of bleeding precautions in the plan of care.

Upon client record review, 1 of 5 (Patient #3) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient 3: Patient has an order for social worker visits monthly, ordered 06/26/2024. There is no evidence of social worker visit 06/26/2024-06/30/2024.