Failure to Coordinate and Document Hospice Services in Care Plans
Penalty
Summary
The facility failed to ensure proper collaboration and communication between hospice providers and facility staff for two residents receiving hospice care. For one resident with Alzheimer's disease, COPD, hemiparesis, and anxiety, the care plan documented receipt of hospice services and provided general instructions for comfort and medication administration. However, it lacked specific details about the hospice services being provided, such as the frequency of support visits, supplies and medical equipment covered by hospice, medications provided, and the hospice provider's contact information. The resident's records confirmed hospice admission, and staff interviews indicated that hospice staff visited regularly, but the care plan was not updated to reflect these arrangements. For another resident with paraplegia, hypertension, a stage 4 pressure ulcer, and osteomyelitis, the care plan noted a terminal prognosis and receipt of hospice services. The plan included directions for comfort measures and collaboration with the hospice team but did not specify which durable medical equipment, supplies, or medications were provided by hospice, nor did it detail the hospice staff involved or the frequency of their visits. Although the resident's electronic medical record contained the hospice plan of care and related documentation, this information was not incorporated into the care plan used by facility staff. Facility policy required coordinated care plans for residents receiving hospice services, including the most recent hospice plan of care and details of care and services provided by both the hospice and the facility. Staff interviews confirmed that care plans should include all relevant hospice information, but this was not consistently done for the residents in question. As a result, the facility did not ensure comprehensive and coordinated care planning for residents on hospice, as required by its own policy.