Every finding on record at White Oak Hospice Inc

Observed in Record Review. In 2 of 4 patient records reviewed, In Visit #1 and RR #1, goals were not measurable: Examples include: increased Knowledge, minimal SOB and minimal edema.

Observed in Record Review. In 3 of 6 patient records reviewed, as noted by the Hospice Surveyor and confirmed by the Administrator, the organization had not planed the patient’s care, treatment, or services based on needs identified by the patient's assessment. Disciplines had PRN visits but did not include reasons for the PRN as per agency policy. Observed in Record Review. In 2 of 4 patient records reviewed, as noted by the Hospice Surveyor and confirmed by the Administrator, the plan of care had not included all services needed for the palliation and management of the terminal illness and related conditions, including the following: - A statement of the scope and frequency of the services necessary to meet the patient’s and family’s needs -Measurable goals Visit #1 did not have frequencies for Chaplain and Social Worker.

Observed in Infection Control System Tracer. It was determined that the organization, as required by Infection Control CoP 484.70(d)(3)(viii) did not have a process for ensuring that all documentation that confirms recognized clinical contraindications to COVID-19 vaccines and supports staff requests for medical exemptions from vaccination had been signed and dated by a licensed practitioner who is not the individual requesting the exemption, and who is acting within their respective scope of practice as defined by, and in accordance with, all applicable state and local laws as evidenced by lack of a policy.