Every finding on record at Saint Iness Hospice Inc

Upon patient record review, 3 of 14 (Patient #7, 9, 10) did not have evidence in the patient record that the comprehensive assessment is updated including and by: • The hospice interdisciplinary group (in collaboration with the individual's attending physician, if any) • Changes that have taken place since the initial assessment • Information on the patient's progress toward desired outcomes • Reassessment of the patient's response to care • The assessment update must be accomplished as frequently as the condition of the patient requires, but no less frequently than every 15 days Patient #7, RN comprehensive assessments completed 5/17/23, 6/10/23, 7/10/23, more than 15 days. Patient #9, RN comprehensive assessments completed 3/8/23, 4/8/23, 5/5/23, more than 15 days. Patient #10, IDG nursing assessment was the identical assessment from 1/9/23 to 7/14/23, this note states on every assessment, consents were signed.

Upon patient record review, 1 of 14 (Patient #8) did not have evidence in the patient record that hospice aide assignments and duties are: • Assigned to a specific patient by a registered nurse that is a member of the interdisciplinary group • Written patient care instructions for a hospice aide must be prepared by a Registered Nurse who is responsible for the supervision of a hospice aide as specified under paragraph (h) of 418.76 • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. The use of “PRN” or “per patient choice”, for any task, whether personal care or non-personal care tasks, are not acceptable Patient #8, Care plan states vitals every visit without parameters noted.

Upon patient record review 2 of 14 (Patient #3,9) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient #3, aide frequency 2x/week at start of care on 5/5/23, first visit was 5/16/23. Patient #9, aide frequency 2x/week visits, only one visit during the weeks of 7/24 and 7/31 on 7/27/23, 7/31/23.