Every finding on record at Virginia In-Home Partner-IV LLC

Based on a review of clinical records and staff interview it was determined the agency failed to ensure care and services were provided in accordance with the patient's plan of care for five (5) of (15) clinical records who received aide visits in the survey sample. Specifically, aide missed visits were not accounted for in the electronic medical records (Clinical records #1, #2, #6, #13 and #15). --- The findings:Nineteen electronic clinical records were reviewed in the agency on 05/05/2023 and 05/08/2023 with read only access. 1. The clinical record for patient #1 was reviewed for the time frame of 01/17/2023 through 04/16/2023. The plan of care for the above noted time frame contained orders for hospice aide to visit the patient three (3) times a week. The clinical record failed to contain documentation of a second and third aide visit or missed visit for the time frame of 01/25/2023 to 01/28/2023. On 05/05/2023 at 2:25 PM, the Business Manager (staff member #7) confirmed the aide missed visits and no missed visit/reason notes documented. 2. The clinical record for patient #2 was reviewed for the time period of 03/31/2023 through 06/28/2023. The plan of care for the above noted time frame contained orders for hospice aide to visit the patient two (2) times a week. The clinical record failed to contain documentation of second aide visit or missed visit for the time frame of 04/02/2023 to 04/08/2023. 3. The clinical record for patient #6 was reviewed for the time period of 10/14/2022 through 01/11/2022. The plan of care for the above noted time frame contained orders for hospice aide to visit the patient five (5) times a week. The clinical record failed to contain documentation of a fifth aide visit or missed visit for the time frame of 10/16/2022 to 10/22/2022. 4. The clinical record for patient #13 was reviewed for the time period of 04/15/2023 through 07/13/2023. The plan of care for the above noted time frame contained orders for hospice aide to visit the patient three (3) times a week. The clinical record failed to contain documentation of a second and third aide visit or missed visit for the time frame of 04/23/2023 to 04/29/2023. On 05/08/2023 at 2:30 PM, (staff member #7) stated, ";The aide was on vacation and there is no documentation of a doctors order to decrease the aides visit that week". 5. The clinical record for patient #15 was reviewed for the time period of 04/12/2023 through 06/10/2023. The plan of care for the above noted time frame contained orders for hospice aide to visit the patient two (2) times a week. The clinical record failed to contain documentation of a second aide visit or missed visit for the time frame of 04/23/2023 to 04/29/2023. On 05/05/2023 at 3:30 PM, (staff member #7) stated, ";The aide was on vacation". The lack of documentation of care being provided in accordance with the patient's plan of care was acknowledged by the Regional Vice President and Business Manager during the clinical record reviews.

Based on personnel file review and staff interview it was determined the agency failed to ensure an agency employee or agency contracted Medical Social Worker with a Master of Social Work Degree (MSW) supervised Medical Social Workers with a Bachelor of Social Work Degree (BSW) who were employed by the hospice after December 2, 2008 as required by the federal regulations for two (2) of (13) personnel files reviewed which two (2) of two (2) were personnel files of Medical Social Workers with a BSW. (Personnel files: #4 and #13). --- Thirteen (13) personnel files were reviewed in the agency on May 4, 2023, and May 8, 2023, with the following findings: 1. The Personnel File of Employee #4 with a date of hire of 03/21/2022. The personal file contained documentation employee was a Medical Social Worker with a BSW degree and the employee obtained a baccalaureate degree in social work on 10/04/2021. The personnel file failed to contain documentation an agency employee with a Master of Social Work Degree or agency contracted Medical Social Worker with a Master of Social Work Degree supervised the employee. 2. The Personnel File of Employee #13 with a date of dire of 03/16/2020. The personnel contained documentation that employee was a Medical Social Worker with a BSW degree, and the employee obtained a baccalaureate degree in social work on 12/14/2002. The personnel file failed to contain documentation an agency employee with a Master of Social Work Degree or agency contracted Medical Social Worker with a Master of Social Work Degree supervised the employee. Interview: During an interview conducted in the agency on May 4, 2023, the Regional Vice President (staff member #6) stated, ";We have a Medical Social Worker with a Masters Degree at the Virginia Beach office", but acknowledged the Medical Social Worker did not supervise the two employees at this office. Staff member #6 stated, ";Thats an oversight on our part". Staff member #6 acknowledged Medical Social workers with a BSW degree and were employed by the hospice after December 2, 2008, who were not supervised by an agency employee or agency contracted Medical Social Worker with a Master of Social Work Degree in the exit conference conducted on May 8, 2023.