Journey Hospice Services, Inc.

“Observed in Record Review. In 10 of 10 active patient records reviewed, a review of the hospice plan of care revealed that patient goals were documented in general terms and were not measurable, making it difficult to evaluate patient progress or the effectiveness of interventions. Goals such as (HOSRRHV#1) patient/cregiver will understand/express understanding of medication/treatment orders and side effects; (HOSRRHV#2) patient/caregiver will understand/express understanding of medication/treatment orders and side effects; (HOSRRHV#3) patient/caregiver will verbalize/express understanding of medication treatment and side effects; To achieve and maintain peripheral circulation for patient comfort; (HOSRRNHV#4) PCG will verbalize having elimination needs met at an acceptable level. (HOSRRNHV#5) PCG will verbalize understanding of treatment orders; (HOSRRNHV#6) PCG will verbalize understanding of non-verbal signs of pain, (HOSRRNHV#7) PCG will be kept clean and dry at all times (HOSRRNHV#8) To maintain mobility and independence. (HOSRRNHV#9) Patient/PCG will verbalize confidence in the management of pain; (HOSRRNHV#10) Patient/PCG will verbalize having urinary elimination needs met at an acceptable level. These goals were documented without defining measurable criteria, or observable outcomes. This finding was discussed and validated by the hospice management team.”

“Observed in Record Review. In 7 of 10 active patient records, it was noted the organization failed to provide care, treatment, or services according to the patient’s individualized plan of care. For example, a review of the clinical record HOSRRHV#1 revealed that hospice aide services ordered at 1 visit per week were not provided as scheduled during the 3rd week of December 2025. Also noted for LVN 1 visit per week were not provided during the 4th week of October 2025 and 2nd week of November 2025. No documentation of patient’s refusal or MD order change. HOSRRHV#2 revealed that hospice aide did not obtain and document vital signs as indicated in the aide care plan. In addition, hospice aide services were ordered two times per week, however only one visit was completed during the fourth week of December 2025. HOSRRNHV#4 revealed that hospice aide services were ordered once per week to provide assistance with activities of daily living (ADLs) beginning the second week of January 2026. However, no hospice aide visits have been completed for more than two weeks following the start date. HOSRRNHV#5 revealed that skilled nursing services by an LVN were ordered once per week. However, no LVN visits were completed during the third week and the fifth week of December 2025. HOSRRNHV#6 revealed that RN supervision of the hospice aide was ordered to occur every 14 days. However, no RN hospice aide supervisory visits were documented during the months of November 2025 and December 2025. HOSRRNHV#8 revealed that skilled nursing services by an LVN were ordered once per week. However, no LVN visits were completed during the last week of October 2025, and the fourth week of December 2025. HOSRRNHV#10 revealed that RN supervision of the hospice aide was ordered to occur every 14 days. However, no RN hospice aide supervisory visits were documented during the third week of December 2025. This finding was discussed and validated by the hospice management team.”

“Observed in Patient Home. In 5 of 9 active patient records with hospice aide services reviewed,, it was noted the organization had failed to ensure that the written patient care instructions for a hospice aide must be prepared by a registered nurse who is responsible for the supervision of a hospice aide. A review of hospice aide assignments revealed missing written instructions regarding patient precautions related to prescribed blood thinner medication. For example HOSRRHV#1 and HOSRRHV#3, patient prescribed Xarelto 10 mg PO daily; HOSRRHV#2, HOSRRNHV#6, and HOSRRNHV#7, patient prescribed Plavix 75 mg PO daily. This finding was discussed and validated by the hospice management team.”

“Observed in Record Review. In 4 of 9 active patient records with hospice aide services,, it was noted the organization failed to ensure that the hospice aide provides services that are ordered by the physician in the plan of care consistent with the aide’s training. A review of the clinical record revealed that the RN provided a written instruction for the hospice aide to obtain and document vital signs at every visit. However for record HOSRRHV#3, the hospice aide did not check or document the patient’s temperature, pulse , and respiration during the visit in the last week of December 2025. For records HOSRRNHV#6, HOSRRNHV#7, and HOSRRNHV#9, the hospice aide was ordered to check and document vital signs at each visit. However, there was no evidence in the record that vital signs were obtained or documented as required. This finding was discussed and validated by the hospice management team.”

“Observed in Record Review. In 6 of 9 patient records with hospice aide services reviewed, it was noted the organization failed to ensure that the registered nurse supervises the hospice aide no less frequently than every 14 days to assess the quality of care and services provided by the hospice aide. For example, a review of clinical record of HOSRRHV#1 revealed that required RN supervision of the hospice aide was not completed within the mandated 14-day timeframe. A gap of 37 days identified between documented RN supervisory visits (between the 3 week of October and rt week of November); For HOSRRHV#2, a gap of 28 days between 3rd week of August 2025 and 2nd week of September 2025, and 28 days gap between 2nd week of November 2025 and 1st week of December 2025. HOSRRHV#3, a gap of 26 days from the time the hospice aide started during the 4th week of December 2025. For HOSRRNHV#6, no evidence documented of the hospice aide supervision. For HOSRRNHV#9, a gap of 28 days between 2nd week of December 2025 and 2nd week of January 2026. Lastly, for HOSRRNHV#10, a gap of 28 days between 1st week of December 2025 and 5th week of December 2025. This finding was discussed and validated by the Hospice Management team.”