Failure to Designate Qualified Hospice Coordinator for Resident Care
Penalty
Summary
The facility failed to designate a qualified hospice coordinator responsible for coordinating care between hospice representatives and facility staff for a resident receiving hospice services. The Medical Records Director (MRD) was assigned as the hospice coordinator, but interviews and record reviews revealed that the MRD's role was limited to ensuring hospice medical records were complete and updated, and he was not involved in coordinating care or participating in the interdisciplinary team (IDT). The MRD's background was in medical billing and quality assurance in home health, and the job description for the Health Record Coordinator did not include hospice coordination responsibilities. A review of the resident's records showed that the resident was admitted with diagnoses including malignant neoplasm of the cervix, palliative care, and cerebral infarction, and was on hospice care with a terminal prognosis. The resident was mostly dependent on mobility and activities of daily living, and had a condition with a life expectancy of less than six months. The care plan indicated the need for cooperative work with the hospice team to meet the resident's needs, but there were missing signatures and incomplete documentation in the hospice binder, which was not updated and could not be located at the time of review. Interviews with facility staff, including the Case Manager and Assistant Director of Nursing (ADON), confirmed that there was no specific individual assigned as hospice coordinator, and that the MRD, who was designated as such, did not have the clinical background or involvement in care coordination required for the role. The facility's policy required collaboration between hospice and facility staff, but the lack of a qualified hospice coordinator led to deficiencies in the coordination and documentation of hospice care for the resident.