Every finding on record at Our Caring Hands Hospice and Palliative Care, LLC.

It is required that the hospice designates a registered nurse member of the IDG to ensure the implementation of the interdisciplinary plan of care. Hospice care and services provided to patients and families follow the individualized plan of care established by the hospice IDG in collaboration with the attending physician (if any). This standard was not met as evidenced by clinical record review and interview. 1 of 11 (9%) clinical records reviewed revealed that nursing services provided were inconsistent with the individualized plan of care as established by the IDG. Record #87408 was reviewed and identified that the patient elected the hospice benefit on 10/25/2021. In the plan of care updates completed on 1/27/2022 and 2/10/2022 the nursing frequency was documented for nursing visits at two times a week, there was one nurse visit completed on the week of 1/31/2022 and 2/7/2022. There was no documented evidence explaining the missed visits. The Director of Nurse (DON) was interviewed on 2/16/2022 and confirmed the clinical record lacked evidence of completion of the missed visits. The DON had no additional information to provide.

It is required that if a patient revokes the election of hospice care or is discharged from hospice per hospice regulation §418.26 (i.e., no longer terminally ill), the hospice forwards to the patient’s attending physician: A copy of the hospice discharge summary and The patient's record, if requested. This standard was not met as evidenced by clinical record review and interview. 2 of 2 (100%) applicable discharged records for patients that revoked hospice services reviewed revealed that there was no documentation of any informaiton sent to the attending physiician. Record #79116 was reviewed and identified that the patient revoked hospice services on 11/30/2021. The RN note on 11/30/2021 documented that a discharge summary was sent to the primary physician. The clinical record did not contain evidence that a discharge summary was completed. There was no documentation of communication with the attending physician. Record #60982 was reviewed and identified that the patient revoked hospice services on 2/10/2022. The RN note on 2/10/2022 documented that a discharge summary was sent to the primary physician. The clinical record did not contain evidence that a discharge summary was completed. There was no documentation of communication with the attending physician. The Director of Nurses was interviewed on 2/16/2022 and stated that they had been using the discharge order as the discharge summary that was sent to the physician. She had no additional information to provide.