Every finding on record at Visiting Angels Hospice Care Inc

Upon client record review, 2 of 14 (Patient #1 & 2) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient 1 & 2: SN visit frequency specified as LVN 1 x weekly and RN 1 x weekly. No documented LVN visits since 6/30/23.

Upon patient record review, 4 of 14 (Patient #3, 5, 7, & 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 3, 5, 7, 8: Aide instructions indicate dress every visit in both street clothes and pajamas. No further instruction on whether pt/cg is to make this determination.

Upon patient record review, 1 of 14 (Patient #8) did not have evidence that before the recertification period for each patient, the medical director or physician designee must review the patient's clinical information and provide written documentation that it is anticipated that the patient's life expectancy is 6 months or less. Patient 8: The narrative contained in the CTI for benefit period #6, 4/27/24-6/25/24 contains a SN narrative note rather than MD composed narrative supporting 6 month prognosis.

Upon patient client record review, 1 of 14 (Patient #6) did not have evidence that each patient record contains: • Signed copies of the notice of patient rights in accordance with 418.52 • Signed election statement in accordance with 418.24 Patient 6: Executed Election Statement contains no evidence of effective date of hospice election date.