Lack of Written Hospice Agreement and Coordination
Penalty
Summary
The facility failed to provide a written agreement with the hospice agency that defined the services to be provided, respective responsibilities, and established a process for communication and collaboration for a resident receiving hospice services. Staff interviews revealed that the Registered Nurse/Infection Preventionist was unable to locate the required hospice agreement and had been attempting to obtain it from the Program of All-Inclusive Care for the Elderly (PACE) agency without success. The RN/IP also stated uncertainty regarding the facility's responsibilities and noted that clinical notes from the hospice provider were not shared with the facility. Additionally, there were no hospice progress notes present in the resident's chart. Further review indicated that the Director of Nursing only recently began receiving hospice notes from the PACE agency, and that a Licensed Vocational Nurse from the contracted hospice agency had admitted and assessed the resident. However, the admitting date and hospice diagnosis were missing from the charts of three residents, including the one sampled. The facility's policy requires a signed agreement outlining responsibilities and a coordinated plan of care, but this documentation was not present or available at the time of the survey.