Upon patient record review, 1 of 5 (Patient #1) did not have evidence in the patient record that hospice aide assignments and duties are: • 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 1: The hospice aide care plan does not specify the frequency of the tasks to be performed by the aide, such as the shower or shampooing the hair. (corrected onsite)
Every finding on record at Sh Hospice Inc.
Simi Valley, California · CCN B51684
2 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 March 2, 2023
2 findingsUpon patient client record review, 5 of 5 (Patient #1, 2, 3, 4, 5) did not have evidence that each patient record contains: • Signed election statement in accordance with 418.24 Patient 1, 2, 3, 4, 5: The election statement does not include information pertaining to notification of hospice noncovered items and services, nor contact information for the BFCC-QIO for appeal. These updates were required effective October 2020.
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Federal survey findings only. State licensure findings for hospices are not shown.
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