Deficiency Index

Every finding on record at Serenity Hospice La LLC

Montrose, California · CCN B31672

3 findings across 1 survey, 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 November 11, 2021

3 findings
L0505

Upon observation, there was no evidence the patient has the right to voice grievances/complaints regarding treatment or care that is (or fails to be) furnished and lack of respect of property by anyone who is furnishing care/service on behalf of the hospice. The designated area on the patient rights form for hospice contact information was blank and did not include the agency phone number in the designated space.

L0531

Upon patient record review, 1 of 5 (Patient #4) did not have evidence in the patient record that the comprehensive assessment includes a bereavement component which includes the needs of the patient's family and other individuals focusing on the social, spiritual, and cultural factors that may impact their ability to cope with the patient's death. Information gathered from the initial bereavement assessment is incorporated into the plan of care and is considered in the bereavement plan of care. Patient #4 There was no evidence of an initial bereavement assessment in the record.

L0679

Upon patient record review, 1 of 5 (Patient #4) did not have evidence that all entries are legible, clear, complete, and appropriately authenticated and dated in accordance with the organizations policies and procedures and currently accepted standards of practice. Electronic signatures are acceptable as long the hospice is following appropriate safeguards to prevent unauthorized access to the patient records. Patient #4- The discharge summary indicated that the patient was discharged from another hospice (H to H Hospice). The discharge summary did not list this agency.

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Federal survey findings only. State licensure findings for hospices are not shown.

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