Failure to Designate Hospice Care Coordinator and Maintain Required Documentation
Penalty
Summary
The facility failed to designate a specific member of the interdisciplinary team (IDT) to coordinate care and communication with hospice providers for two residents receiving hospice services. Facility policy and a written agreement required the identification of a responsible party for this coordination, as well as the implementation of a collaborative care plan between the facility and hospice. However, record reviews for both residents revealed no documentation of a designated staff member responsible for coordinating hospice care, nor evidence of required hospice documentation such as the hospice election form, physician certification of terminal illness, or the most recent hospice care plan. For one resident with Alzheimer's disease, severe malnutrition, and significant cognitive impairment, the medical record lacked documentation of a designated coordinator, hospice election form, physician certification, and a current hospice care plan. The resident's care plan referenced hospice services but did not specify what those services were or include the hospice care plan. For the second resident, who had cancer, severe malnutrition, and was cognitively intact, similar documentation gaps were found, including the absence of a designated coordinator, hospice election form, and physician certification. Interviews with facility staff and hospice personnel confirmed that the process for coordinating hospice care was not followed. Staff were unaware of the required documentation and the need for a designated coordinator, and communication between the facility and hospice was inconsistent. The administrator acknowledged that there was no appointed staff member for hospice coordination and was not aware of the regulatory requirement to designate one in writing.