Upon patient client record review, 1 of 5 (Patient #3) 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 #3: Election of benefit form did not have a date listed for the effective date. The election of statement form also did not have a signature from the patient/representative.
Every finding on record at Zd Hospice Care Inc
Van Nuys, California · CCN B51742
1 finding across 1 survey, in the inspector's own words.
The inspector’s own words from form CMS-2567, unedited, including CMS’s own spacing. Names and some dates are redacted by CMS.
Survey of July 7, 2023
1 finding← Back to the Zd Hospice Care Inc record
Federal survey findings only. State licensure findings for hospices are not shown.
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