Enhabit Hospice Prattville

“It is required that hospice aides must report changes in the patient’s medical, nursing, rehabilitative, and/or social needs to a registered nurse as the changes relate to the plan of care and any quality assessment and improvement activities. The hospice aide must also complete appropriate records of service, including the report of changes in the patient’s needs. Hospice aide documentation complies with hospice policies and procedures. This standard was not met, as evidenced by clinical record review and interview. In 3 of 16 (19%) clinical records with hospice aide services reviewed revealed that the agency did not ensure the hospice aide notified the registered nurse of the changes in the patient’s plan of care. CLINICAL RECORD 1: The patient’s date of election was 01/23/2026. The Hospice Plan of Care dated 01/25/2026 stated bathing (bed bath), dressing, foot care, hair care, medications: observe & remind, passive/active ROM [range of motion], perineal care, routine catheter care, shampoo once per week and per caregiver request, turn and position in bed, observe for change in condition, 2 patient identifiers used this visit, bleeding precautions, fall precautions, and oxygen precautions. The Hospice Plan of Care dated 02/04/2026 stated bathing (bed bath), clean nails, dressing, hair care, medications: observe & remind, oral care, perineal care, routine catheter care, shampoo once per week, skin care (lotion), turn and position in bed, change linens once per week, empty trash, indicate date of last BM, observe for change in condition, 2 patient identifiers used this visit, bleeding precautions, fall precautions every visit keep siderails up when patient is unattended, and oxygen precautions. The Hospice Aide Visit dated 01/28/2026 documented, “medications observe & remind completed: N [no] Note: NA [not applicable], routine catheter care completed: N Note: Pt do not have cath [catheter], passive/active ROM completed: N Note: N/A.” The Hospice Aide Visit dated 01/30/2026 documented, “medications observe & remind completed: N Note: Daughter gives medications, shampoo completed: N Note: patient refused, routine catheter care completed: N Note: Pt do not have cath, passive/active ROM completed: N Note: patient refused.” The Hospice Aide Visit dated 02/02/2026 documented, “medications observe & remind completed: N Note: Daughter gives medications, shampoo completed: N Note: patient refused, routine catheter care completed: N Note: Pt do not have cath, passive/active ROM completed: N Note: patient refused.” The Hospice Aide Visit dated 02/09/2026 documented, “medications observe & remind completed: N Note: patient refuse, and routine catheter care completed: N Note: Pt do not have cath.” The Hospice Aide Visit dated 02/18/2026 documented, “medications observe & remind completed: N Note: patient refuse, and routine catheter care completed: N Note: Pt do not have cath.” The documentation lacked evidence that the aide had notified the registered nurse of changes to the plan of care. CLINICAL RECORD 7: The patient’s date of election was 02/04/2026. The Hospice Plan of Care dated 02/04/2026 stated bathing (bed bath), clean nails, dressing, hair care, oral care, shampoo, skin care (lotion), turn and position in bed, change linens, empty trash, indicate date of last BM [bowel movement], fall precautions, and swallowing precautions. The Hospice Aide Visit dated 03/06/2026 documented, “shampoo completed: N Note: patient refused.” The Hospice Aide Visit dated 03/11/2026 documented, “bathing (bed bath) completed: N Note: Caregiver provided care; shampoo completed: N Note: Caregiver provided care; oral care completed: N Note: Caregiver provided care; dressing completed: N Note: Caregiver provided care.” The documentation lacked evidence that the aide had notified the registered nurse of changes to the plan of care. CLINICAL RECORD 19: The patient’s date of election was 08/30/2026. The Hospice Plan of Care dated 08/31/2025 stated bathing (bed bath), dressing, routine catheter care, skin care (lotion), turn and position in bed, change linens once per week and per caregiver request, empty trash, empty urinal drainage bag, observe for change in condition, seizure precautions, gastrostomy tube precautions, oxygen precautions, swallowing precautions, wound precautions. The Hospice Aide Visit dated 12/10/2025 stated turn and reposition in bed, patient (bed bath), skin care (lotion), routine catheter care, dressing, empty trash, and change linens were documented as caregiver-provided care. The documentation lacked evidence that the aide had notified the registered nurse of changes to the plan of care. During a joint clinical record review and interview on 03/13/2026, the Director of Operations (Personnel Record 1) confirmed that the hospice aide’s documentation lacked notification to the registered nurse of the changes in the plan of care.”

“It is required that a patient’s clinical record, containing past and current findings, is maintained for each hospice patient. The record contains correct clinical information that is available to the patient’s attending physician and hospice staff. The record may be maintained electronically or on paper. Each patient’s record includes, at a minimum, signed copies of the notice of patient rights and the hospice election statement. This standard was not met, as evidenced by clinical record review and interview. In 1 of 19 (5%) clinical records reviewed revealed that the agency did not ensure the patient’s signed consents included the date of election. CLINICAL RECORD 5: The patient elected the hospice benefit on 10/29/2025. The consent forms, signed and dated 10/29/2025, had a space for the date of election, but the space was left blank. During a joint clinical record review and interview on 03/13/2026, the Director of Operations (Personnel Record 1) confirmed that the patient’s signed consent lacked the hospice date of election.”