Failure to Coordinate and Document Hospice Services and Agreements
Penalty
Summary
The facility failed to ensure proper coordination and implementation of hospice services for three residents with severe cognitive impairment and dependence on staff for all activities of daily living. Each resident was enrolled in hospice care, but their care plans lacked specific interventions detailing the services to be provided by hospice or the facility staff. Documentation in both the electronic medical record and hospice binders did not show evidence of a collaborative plan of care for any of the residents reviewed. Interviews with nursing staff, including LPNs and CNAs, revealed a lack of awareness regarding the roles and responsibilities of hospice staff, the schedule of hospice visits, and the specific care or services hospice was expected to provide. Staff reported that they only became aware of hospice involvement when they observed hospice staff in the residents' rooms, and there was no written communication or documentation to inform them of hospice activities or responsibilities. Additionally, a review of the hospice agreement for one resident showed that the agreement was unsigned by both the hospice entity and the facility, with the administrator acknowledging that a new agreement had not been signed after the hospice company changed its name. Facility policy required a signed agreement before hospice care was furnished and mandated that each resident's plan of care include both the hospice plan and a description of services provided by the facility, which was not met in these cases.