Failure to Include Hospice Services in Resident Care Plan
Penalty
Summary
The facility failed to develop and implement a comprehensive care plan addressing hospice care for a resident who was admitted with a history of anxiety disorder and major depressive disorder and was receiving hospice services. Documentation review showed that although the resident's admission orders included hospice care and restrictions on hospitalization and routine tests, there was no evidence in the care plan to indicate hospice services were addressed. The quarterly Minimum Data Set (MDS) confirmed the resident was on hospice, but the care plan did not reflect this, nor did it specify the services to be provided by the hospice agency. Interviews with facility staff, including the MDS Coordinator and the Director of Nursing (DON), confirmed that hospice care was not included in the resident's care plan. The MDS Coordinator acknowledged the omission and stated that hospice should be included so staff are aware of the services and the involvement of the hospice team. The DON also stated that the care plan should include the reason for hospice admission and any specific requests from the resident or family. The Executive Director confirmed the expectation that hospice care be identified in the care plan.