Every finding on record at VNA Home Health & Hospice Services Inc.

Based on interview and record review, it was determined that the hospice agency failed to ensure that the plan of care for visit frequencies was followed as ordered for 5 of 16 charts reviewed in a final sample of 19 patients (Patient Identifiers are #2, #6, #8, #9 and #14). Findings include: --- Resident #2 Review on 11/5/24 of Patient #2's Hospice Plan of Care, dated 3/15/24, revealed a physician's order for Physical Therapy (PT) 1 time every 14 days starting 3/18/24 and for a Hospice Aide (HA) starting 3/17/24 for 5 times a week. Review on 11/5/24 of Patient #2's visits for the certification period of 3/15/24 to 4/26/24 revealed on 3/26/24 there was a missed PT visit that was not rescheduled during the 14 days. Further review revealed a missed HA visit on 4/4/24 resulting in only 4 days of HA that week. There was no notification to the practitioner about the missed visits. Interview on 11/5/24 at 1:15 p.m. with Staff A (Clinical Supervisor) confirmed the above findings. Resident #6 Review on 11/6/24 of Patient #6's Hospice Plan of Care, dated 8/13/24, revealed a physician's order for HA 3 visits every week for 12 weeks. Review on 11/6/24 of Patient 6's visits for the certification period of 8/13/24 to 11/6/24 revealed there were missed HA visits on 8/28/24, 10/3/24 and 10/22/24, resulting in not receiving the ordered HA visits per week. There was no documentation that the practitioner was notified about the missed visits. Interview on 11/6/24 at 8:30 a.m. with Staff A confirmed the above findings. Patient #8 Review on 11/6/24 of Patient #8's Hospice Plan of Care, dated 8/20/24, revealed a physician's order for HA 1 visit every week for 13 weeks. Review on 11/6/24 of Patient #8's visits for the certification period of 8/20/24 to 11/6/24 revealed there were missed HA visits on 9/3/24 and 9/12/24, resulting in not having HA during those weeks. There was no documentation that the practitioner was notified of the missed visits. Interview on 11/6/24 at 9:20 a.m. with Staff A confirmed the above findings. Patient #9 Review on 11/6/24 of Patient #9's Hospice Plan of Care, dated 10/27/24, revealed a physician's order for HA 3 visit every week for 13 weeks. Review on 11/6/24 of Patient #9's visits for the certification period of 10/27/24 to 12/25/24 revealed there was a missed HA visit on 10/28/24, resulting in only 2 HA visits that week. There was no documentation that the practitioner was notified of this missed visit. Interview on 11/6/24 at 9:25 a.m. with Staff A confirmed the above findings. Patient #14 Review on 11/6/24 of Patient #14's Hospice Plan of Care, dated 6/28/24, revealed a physician's order for HA 3 visits every week for 12 weeks. Review on 11/6/24 of Patient #14's visits for the certification period of 6/28/24 to 9/28/24 revealed there were missed HA visits on 8/14/24, 8/10/24, 9/2/24 and 9/20/24, resulting in only 2 HA visits those weeks. There was no documentation that the practitioner was notified of these missed visits. Interview on 11/6/24 at 11:45 a.m. with Staff A confirmed the above findings.