Aveanna Hospice of Scottsboro

“It is required that a hospice aide provides services ordered by the Interdisciplinary Group, included in the plan of care, permitted to be performed under state law and regulation, and consistent with the hospice aide training. This standard was not met as evidenced by clinical record review, interview and observation. In 1 of 1 (100%) home visits that were conducted in a private home, the agency did not ensure that the hospice aide provided services as ordered by the Interdisciplinary Group and included in the plan of care. CLINICAL RECORD 3/HOME VISIT 3: This patient elected the hospice benefit on 07/01/2025 with a terminal diagnosis of benign neoplasm of the meninges. The effective date of the hospice aide (HA) care plan was 09/29/2025-12/27/2025. The hospice plan of care reviewed for the dates of 09/29/2025-12/27/2025 ordered hospice aide visits 2 times a week. The HA care plan directed the HA to provide bathing-seated shower using chair/bench. An observed home visit was conducted with the HA [PERSONNEL RECORD 3] on 11/24/2025. The HA was observed to give the patient personal care. The HA provided a sponge bath while the patient sat on the toilet. The HA stated that the patient decided between a sponge bath on the toilet or a shower using the shower bench. The HA did not provide a seated shower using a chair/bench as assigned in the HA care plan. An interview was conducted with the Executive Director on 11/24/2025 and it was stated that the HA did not follow the HA care plan. The Executive Director stated that the HA care plan would be updated to reflect the goals of the patient.”

“It is required that the designated IDG member provides the SNF/NF or ICF/IID with the following information for each patient/resident: the hospice election form and any advance directives, physician certification and recertification of the terminal illness. This standard was not met as evidenced by clinical record review, interview and observation. In 1 of 1 (100%) home visits that were conducted in a skilled nursing facility, the agency did not ensure that the skilled nursing facility was provided with the hospice election form, any advance directives, or the physician certification and recertification of the terminal illness. CLINICAL RECORD 1/HOME VISIT 1: This patient elected the hospice benefit on 12/21/2024 with a terminal diagnosis of severe protein calorie malnutrition. An observed home visit was conducted on 11/24/2025 in a skilled nursing facility with the Licensed Master’s Social Worker [LMSW - Personnel Record 1]. The hospice binder was reviewed with the LMSW and revealed the hospice election form and advance directives were not present in the hospice binder. Additionally, the physician certification and recertification of the terminal illness were not present in the binder. An interview was conducted with the Executive Director on 11/25/2025. It was stated that the Executive Director visited the skilled nursing facility after the home visit on 11/24/2025 and confirmed the hospice election form and advance directives as well as the physician certification and recertification of the terminal illness were not present in the binder or in the facility clinical records. She reported the facility would sometimes remove documentation from the hospice binder and either place it in the facility clinical records or shred the forms.”

“It is required that the designated IDG member provides the SNF/NF or ICF/IID with the following information for each patient/resident: the hospice election form and any advance directives, physician certification and recertification of the terminal illness. This standard was not met as evidenced by clinical record review, interview and observation. In 1 of 1 (100%) home visits that were conducted in a skilled nursing facility, the agency did not ensure that the skilled nursing facility was provided with the hospice election form, any advance directives, or the physician certification and recertification of the terminal illness. CLINICAL RECORD 1/HOME VISIT 1: This patient elected the hospice benefit on 12/21/2024 with a terminal diagnosis of severe protein calorie malnutrition. An observed home visit was conducted on 11/24/2025 in a skilled nursing facility with the Licensed Master’s Social Worker [LMSW - Personnel Record 1]. The hospice binder was reviewed with the LMSW and revealed the hospice election form and advance directives were not present in the hospice binder. Additionally, the physician certification and recertification of the terminal illness were not present in the binder. An interview was conducted with the Executive Director on 11/25/2025. It was stated that the Executive Director visited the skilled nursing facility after the home visit on 11/24/2025 and confirmed the hospice election form and advance directives as well as the physician certification and recertification of the terminal illness were not present in the binder or in the facility clinical records. She reported the facility would sometimes remove documentation from the hospice binder and either place it in the facility clinical records or shred the forms.”