Every finding on record at Pruitthealth Hospice, Inc.

Based on review of clinical records, and staff interview, it was determined that the hospice agency failed to ensure the initial comprehensive assessment was completed within 48 hours after the election of hospice care for three of 13 sampled Patients (P) (P#4, P#5, P#6). --- 1. Record review of the documents titled ";Patient Face Sheet" for (P#4), revealed a diagnosis of type 2 diabetes mellitus with hyperglycemia (a disease that occurs when your blood glucose, also called blood sugar, is too high), acute post hemorrhagic anemia (a condition in which a person quickly loses a large volume of circulating hemoglobin), chronic obstructive pulmonary disease unspecified (a chronic inflammatory lung disease that causes obstructed airflow from the lungs), gastrointestinal hemorrhage unspecified (forms of bleeding in the gastrointestinal tract, from the mouth to the rectum), chronic pain, and essential hypertension (refers to high blood pressure with no other medical condition). Record review of the document titled ";Skilled Nursing Visit" revealed that the admission was done on 12/28/2022, but the initial skilled nurse assessment was completed on 1/2/2023, (five days) after the election of hospice care. The clinical record lacked documentation regarding the staff's delay in completing the assessments. 2. Record review of the document titled ";Patient Face Sheet" for (P#5), revealed a diagnosis of abdominal aortic aneurysm, without rupture (a bulge in the lower part of the aorta, the largest blood vessel running from the heart through the chest and abdomen), presence of cardiac pacemaker (a small device that's placed (implanted) in the chest to help control the heartbeat), gastroesophageal reflux disease with esophagitis (a condition that develops when there is a retrograde flow of stomach contents back into the esophagus), and essential hypertension (refers to high blood pressure with no other medical condition). Record review of the document titled ";Skilled Nursing Visit" revealed that the admission was done on 1/8/2021, but the initial skilled nurse assessment was completed on 1/11/2021, (three days) after the election of hospice care. The clinical record lacked documentation regarding the staff's delay in completing the assessments. 3. Record review of the document titled ";Patient Face Sheet" for (P#6), revealed a diagnosis of malignant pericardial in diseases effusion (the buildup of too much fluid in the double-layered, saclike structure around the heart (pericardium)), ischemic cardiomyopathy (a condition of weakened heart muscles due to heart attack or coronary heart disease), type 2 diabetes (condition results from insufficient production of insulin, causing high blood sugar), and essential hypertension (refers to high blood pressure with no other medical condition). Record review of the document titled ";Skilled Nursing Visit" revealed that the admission was done on 12/29/2022, but the initial skilled nurse assessment was completed on 1/1/2023, (72 hours) after the election of hospice care. The clinical record lacked documentation regarding the staff's delay in completing the assessments. In an interview on 1/24/2023 at 4:15 p.m., the Director Health Services (DHS) revealed she did not know why the admission nurse completed the admission late. The DHS also confirmed that the surveyor has been provided with all available documentation for the patients records.