Failure to Coordinate and Discontinue Hospice Services per Family Request
Penalty
Summary
The facility failed to provide appropriate hospice services to a resident by not designating a specific member of the interdisciplinary team to coordinate care between the facility and the hospice agency, as required by policy. The Social Service Director (SSD) was acting as the coordinator but was not formally identified in the facility's policy, and this lack of clear designation contributed to communication failures. The SSD did not document conversations with the resident's responsible party (RP) or the hospice agency regarding the request to discontinue hospice services, nor did she inform the physician or facility administration of the request. The resident in question had a history of falling, muscle weakness, cerebrovascular disease, seizures, and was receiving palliative care. The resident was dependent on staff for all activities of daily living and was under hospice care for a diagnosis of cerebrovascular accident. The responsible party requested on multiple occasions that hospice services be discontinued and expressed a desire to transfer the resident to another facility. Despite these requests, hospice staff continued to visit and provide services after the request to end hospice care had been made. Interviews revealed that the hospice agency did not receive notification from the facility to discontinue services, and the SSD acknowledged not documenting or communicating the responsible party's wishes appropriately. The facility's policy on hospice care did not specify who was responsible for coordinating care, and the SSD admitted to not fulfilling her responsibilities in this regard. The lack of documentation and communication resulted in the resident continuing to receive hospice services against the wishes of the responsible party.