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F0849
D

Failure to Maintain Required Hospice Documentation and Communication

Versailles, Ohio Survey Completed on 05-08-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure that required hospice provider contracts, plans of care, and communication binders were available for a resident receiving hospice services. Medical record review showed that a resident with multiple diagnoses, including epilepsy, hypertension, anxiety, paranoid schizophrenia, and depression, was admitted and had a physician order for hospice services due to intracranial hemorrhage. However, there was no documentation of the hospice provider agreement or plan of care in the resident's medical record. During the survey, staff interviews revealed that a hospice communication binder was not present in the facility for the resident, and there was no sign-in sheet for hospice staff visits. The RN confirmed the absence of the hospice provider agreement, plan of care, and staff signature logs, and stated that the hospice provider had been contacted to bring the necessary documents. The DON also confirmed that the hospice provider agreement and plan of care were not available in the facility until the day of the interview, and there were no hospice staff signature logs or communication binder present prior to that.

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