Failure to Obtain Physician Order for Hospice Care
Penalty
Summary
The facility failed to follow professional standards of clinical practice by not obtaining a physician's order for hospice care for a resident who was receiving hospice and end-of-life care. The resident, who was cognitively intact and had diagnoses including chronic heart failure and chronic kidney disease, was documented in the care plan as having a terminal prognosis and was receiving hospice services. However, a review of the physician order summary revealed that while there were orders for hospice education and a palliative consult, there was no specific physician order for hospice care at the time hospice services were initiated. During interviews, the DON confirmed that a physician's order is required for residents enrolled in hospice care, and acknowledged that such an order was missing for this resident. The facility's hospice care policy did not specify the need to obtain a physician's order prior to starting hospice services. The deficiency was identified when the surveyor reviewed the resident's records and discussed the findings with facility leadership.