Based on record review and staff interview, the hospice failed to maintain a volunteer program that provided service hours equivalent to at least 5% of paid patient care hours. --- Findings include:Review of the provider’s documentation reveals they had 4916.71 volunteer hours and 276,201.97 paid direct care hours from 4/1/24 to 3/31/25. Thus, volunteer hours were equivalent to 1.78% of the paid direct care hours. Furthermore, review of the Volunteer Patient Visit List for 2024 reveals “impossible hours” for 3 random dates for which one volunteer was checked on each. On 06/20/24, Volunteer AA had entries for 2-hour visits with 20 patients for a total of 40 hours. On 07/30/24, Volunteer BB had entries for 31 2-hour patient visits for a total of 62 hours that day. On 08/29/24, Volunteer AA had entries for 30 2-hour patient visits for a total of 60 hours that day. During interview on 04/15/25 beginning at 3:12 PM, the Director of Human Resources said the previous Volunteer Coordinator left employment in September 2024, so she and the Vice President of Market Research and Development have been running the volunteer program together in addition to their regular duties.
Every finding on record at Opus Care of South Florida
Miami, Florida · CCN 101536
2 findings across 2 surveys, in the inspector's own words.
The inspector’s own words from form CMS-2567, unedited, including CMS’s own spacing. Names and some dates are redacted by CMS.
Survey of April 22, 2025
1 findingSurvey of November 9, 2022
1 findingBased on record review and interview, the provider failed to demonstrate that training in emergency preparedness policies and procedures was provided to all new and existing staff, individuals providing services under arrangement, and volunteers, consistent with their expected role. (Staff N and Staff P) --- Findings include: Volunteer records review revealed the Staff N has a start of date of volunteering as of 11/12/2021 and Staff P has a start of date of volunteering as of 10/30/2018. The provider is unable to demonstrate that Volunteers Staff N and Staff P have received additional training in emergency preparedness policies and procedures. On 11/092/2022 at 10:42 AM, the Administrator acknowledged not conducting further training in their emergency preparedness policies and procedures other than upon initial for all volunteers.
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