Failure to Coordinate Hospice Services for a Resident
Penalty
Summary
The facility failed to ensure the coordination of hospice services with facility services to meet the needs of a resident, identified as Resident R59, for end-of-life care. The facility's policy on hospice services, dated 1/2/25, requires collaboration with hospice representatives and coordination of facility staff participation in the hospice care planning process. However, a review of Resident R59's clinical records revealed that the facility did not provide appropriate physician orders for hospice care, which should have included the hospice diagnosis, the hospice provider, and contact information. Additionally, the current care plan for Resident R59 did not include a plan of care for hospice services by the facility. Resident R59 was admitted to the facility with diagnoses of heart failure, dysphagia, and high blood pressure. The MDS assessment indicated that hospice services were required, but the facility failed to document the necessary hospice information in the physician orders. Interviews with the Registered Nurse Assessment Coordinator and the Nursing Home Administrator confirmed these deficiencies, highlighting the facility's failure to coordinate hospice services effectively for Resident R59.
Plan Of Correction
The care plan and physician orders for R59 have been updated to include a diagnosis for hospice care, the provider and their contact information. Additionally, the care plan was reviewed/updated to ensure it was comprehensive to include hospice services. Staff including RNs, LPNs, and Unit Managers as well as providers will receive additional training on the needed components of hospice orders and the need for comprehensive care plans. Four residents receiving hospice care with a focus on those most recently admitted to hospice will be reviewed weekly for three weeks to ensure they have the proper provider order as well as a comprehensive care plan. Then two residents receiving hospice services will be reviewed weekly for three weeks to ensure complete hospice orders and comprehensive care plans. Any deficient practice will be immediately corrected. All data will be forwarded to the QAPI committee and the need for additional monitoring will be determined by the committee.