Every finding on record at Transitions Hospice, Inc

Based on record reviews and staff interview, it was determined that the agency Interdisciplinary Team (IDT) failed to ensure Certified Nursing Assistant (CNA) care and services were provided as ordered in the plan of care (POC) by the agency Medical Doctor (MD) for three patients (P) (P#8, P#9, P#10) of 10 sampled records reviewed. --- The findings include: 1. Review of the POC for P#8 revealed the CNA services were ordered two times a week for certification period (start of care) 7/31/2023 through 10/28/2023. It was determined the CNA did not provide services for P#8 during week one. Additionally, CNA services failed to be provided for one of two days during week three as ordered. 2. Review of the POC for P#9 reveals the CNA services were ordered two times a week for certification period 7/12/2023 through 8/11/2023. It was determined CNA services failed to be provided to P#9 for one of the two days during week three as ordered. 3. Review of the POC for P#10 reveals the CNA services were ordered three times a week for certification period 9/8/2023 through 10/8/2023. It was determined the CNA services failed to be provided to P#10 for one out of three days during week two as ordered. During an interview with the agency Administrator on 10/3/2023 at 1:30 p.m., revealed she was not aware of the missed visits for P#8, P#9, or P#10. Furthermore, she stated after reviewing the charts the CNA did not put a note for missed visits for P#8, P#9, and P#10 during the certifications reviewed by surveyor.