Every finding on record at Q Hospice LLC

It is required that the hospice Interdisciplinary Group, in consultation with the individual's attending physician (if any), completes an initial comprehensive assessment no later than five (5) calendar days after the election of hospice care, in accordance with CMS §418.24–the elements of the hospice care election statement. This standard was not met as evidenced by clinical record review and interview. In 1 of 7 (14%) clinical records reviewed it was revealed that the social worker did not complete the initial comprehensive assessment within 5 days after the election of the hospice benefit. Clinical Record 1: The patient elected the hospice benefit on 07/05/2023. The initial social work assessment was not completed up to the date of review 07/11/2023 which was 6 days after the election of hospice care. The RN asked the patient/caregiver a few psychosocial questions but did not complete an in-depth initial psychosocial assessment. In interviews on 07/11/2023 and 07/12/2023, the Director of Clinical Services confirmed that the Social Worker did not perform an initial psychosocial assessment. No further information was provided. The Social Worker was interviewed. on 7/12/2023 and confirmed that she did not perform an initial assessment.

It is required that the documented comprehensive assessment includes a drug profile that contains the patient's current, prescription and over-the-counter (OTC) drugs, supplements, herbal remedies and other alternative treatments that could affect drug therapy. The drug profile is updated per the hospice policy and procedure, but, at minimum, at the time of each comprehensive assessment and/or when new medication is added or changes are made to existing medication. This standard was not met as evidenced by clinical record review and interview. In 1 of 7 (14%) clinical records reviewed it was revealed that the agency did not ensure the drug profiles were accurate and updated to include all orders. Clinical Record 3: The Patient elected the hospice benefit on 06/16/2023. A physician order for oxygen 2 liters per minute (LPM) by nasal cannula (NC) was entered on 06/16/2023. Oxygen was not added to the patient's list of medications on the medication profile up to review date 07/11/2023. Twenty-five (25) days after the order was written. In interviews on 07/11/2023 and 07/12/2023, the Director of Clinical Services confirmed that oxygen was not on the patients' medications profile or in the Plan of Care/Interdisciplinary Group documentation or updates. no further information was provided.