Aria Hospice Comfort Care

“It is required that the documented comprehensive assessment includes a drug profile that contains the patient’s current: prescription and over the counter (OTC) drugs; supplements; herbal remedies; other alternative treatments that could affect drug therapy. The drug profile is updated per the hospice policy and procedure, but, at minimum, at the time of each comprehensive assessment and/or when new medication is added or changes are made to existing medication. This standard was not met as evidenced by clinical record review, observation, and interview. In 1 of 19 (5%) clinical records reviewed revealed the hospice did not ensure the drug profile was updated to include all current medications. HOME VISIT 4/CLINICAL RECORD 4: The patient elected the hospice benefit on 08/05/2025 with a diagnosis of Alzheimer’s disease. The hospice medication profile reviewed on 02/26/2026 included “haloperidol (2mg/ml) 0.25 ml oral every 6 hours as needed for agitation.” During the home visit on 02/26/2026, the facility medication profile was reviewed. Haloperidol (2mg/ml) 0.25 ml oral every 6 hours as needed for agitation was not included on the facility medication profile. The registered nurse visit dated 02/23/2026 did not include evidence that an update to the facility medication profile was documented. During an interview with the clinical services director on 02/27/2026, the clinical services director contacted the facility medication tech by phone to verify that the medication profile did not include haloperidol. The facility medication tech verified that haloperidol was inadvertently omitted from the medication profile in January 2026. The clinical services director stated, “The nurse should have identified the discrepancy during her routine visits. I will advise the nurse to be sure to reconcile the medication profile during each visit.””

“It is required that the hospice follows accepted standards of practice to prevent the transmission of infections and communicable disease, including the use of standard precautions, such as hand hygiene. This standard was not met as evidenced by document review, interview and observation. In 1 of 4 (25%) home visits in which hand hygiene was observed, the agency did not ensure that the hospice followed accepted standards of practice to prevent the transmission of infections and communicable disease, including the use of standard precautions, such as hand hygiene. DOCUMENT 2: The policy “HAND HYGIENE” stated in relevant parts; “Procedure/best practice. 3. Hand decontamination using an alcohol-based hand rub should be performed: F. When moving from a contaminated body site to a clean body site during patient care.” HOME VISIT 4: The patient elected the hospice benefit on 08/05/2025 with a diagnosis of Alzheimer’s disease. During the home visit with the hospice aide (PR8), the hospice aide provided a bed bath. The hospice aide was observed washing her hands with soap and water prior to donning gloves. She then began bathing the patient starting with her upper body and progressing downward toward her lower body. She then washed the patient’s private areas (a contaminated body site). After washing and drying the patient’s private areas, the hospice aide applied lotion to her soiled gloves and applied the lotion to the patient’s upper body, arms, and back. She did not remove the soiled gloves and sanitize her hands before applying lotion to clean body parts. During an interview with the clinical services director on 02/27/2026, he stated, “The hospice aide should have changed her gloves and sanitized her hands after washing the patient’s private areas and before applying lotion to the rest of her body. I will speak to her about that.””

“A clinical record containing past and current findings is maintained for each hospice patient. The clinical record must contain correct clinical information that is available to the patient’s attending physician and hospice staff. The patient’s record must include physician orders. This standard was not met as evidenced by clinical record review and interview. In 1 of 1 (100%) clinical records reviewed of patients who were discharged live from hospice, the agency did not ensure a written physician’s discharge order was documented. CLINICAL RECORD 16: The patient elected the hospice benefit on 09/26/2025 with a diagnosis of sequelae of unspecified infectious and parasitic disease and was discharged on 10/17/2025 to an out of service area/non-contracted facility (hospital). There was no documented evidence of a written physician’s discharge order to discharge the patient from the hospice. During an interview with the chief of operations (COO) on 02/27/2026, she stated, “I was not aware that a discharge order was required when the patient chooses to go to the hospital.””

“It is required that if the care of a hospice patient is transferred to a Medicare/Medicaid certified facility, the hospice forwards to the receiving facility a copy of the hospice discharge summary and the patient’s record, if requested. This standard was not met as evidenced by clinical record review and interview. In 1 of 1 (100%) clinical records reviewed of patients who were transferred to a Medicare/Medicaid certified facility, the agency did not ensure that hospice forwarded a copy of the discharge summary to the Medicare certified facility. CLINICAL RECORD 16: The patient elected the hospice benefit on 09/26/2025 with a diagnosis of sequelae of unspecified infectious and parasitic disease and was discharged on 10/17/2025 when transferred to a hospital, (Medicare certified facility), to seek aggressive treatment. There was no documented evidence in the clinical record that a discharge summary was sent to the Medicare certified facility/hospital. During an interview with the chief operations officer, she stated, “I was not aware of the need to send a discharge summary to the hospital.””