Progressive Home Health & Hospice

“Based on record review and staff interview, the agency failed to ensure that each patient received an accurate, patient specific comprehensive assessment that included an initial bereavement assessment for 14 of 14 sample patients (Patients 1 - 14). This failed practice by the hospice placed all patients and their families at risk of unmet needs related to their bereavement plan of care. Findings Include: Review of clinical records for Patients 1 through 14, that included the start of care comprehensive assessment, lacked documented evidence of an initial bereavement assessment included as a part of the comprehensive assessment. During an interview on 08/13/24 at 2:45 PM, Staff A, Administrator, stated that there was really no place to document the bereavement assessment in the EMR (Electronic Medical Record). She confirmed the above findings of failing to ensure an initial bereavement assessment as part of the start of care comprehensive assessment.”

“Based on record review and staff interview, the Hospice failed to ensure hospice aide supervisory visits were completed no less than every 14 days as required for 6 of 7 patients reviewed (Patients 1-5, 7.) This failure to ensue supervision of hospice aide services every 14 days as required, has the potential to affect the quality of care being provided to patients and the timely adjustment of the plan of care to meet the changing needs patients. Findings Include: Patient 1 Review of Patient 1’s Hospice Certification and Plan of Care, for the certification period dated 06/23/24 to 08/21/24, confirmed an order for hospice aide services for assistance with personal care two times per week. There were documented aide visits being made each Tuesday and Thursday throughout the episode however, there were no documented aide supervisory visits by a Registered Nurse (RN) performed during the episode. The patient’s Start of Care date was found to be 10/27/23 with no documented aide supervision during services. Patient 2 Review of Patient 2’s Hospice Certification and Plan of Care, for the certification period dated 06/04/24 to 08/02/24, confirmed an order for hospice aide services for assistance with personal care one time per week and two time per week starting on 06/30/24. There were documented aide visits as ordered throughout the episode however, there were no documented aide supervisory visits by an RN performed during the episode. The patient’s Start of Care date was found to be 12/07/23 with no documented aide supervision during services. Patient 3 Review of Patient 3’s Hospice Certification and Plan of Care, for the certification period dated 07/11/24 to 09/08/24, showed an order for hospice aide services for assistance with personal care one time per week for eight weeks. There were documented aide visits made on Thursday 07/18/24, 07/25/24, 08/01/24, and 08/08/24 however, there were no documented aide supervisory visits by an RN performed during the episode. The patient’s Start of Care date was found to be 07/11/24 with no documented aide supervision during services. Patient 4 Review of Patient 4’s Hospice Certification and Plan of Care for the certification period dated 06/17/24 to 09/14/24, revealed an order for hospice aide services for assistance with personal care two times per week. There were documented aide visits made on Tuesday and Thursday throughout the episode however, there were no documented aide supervisory visits by an RN performed during the episode. The patient’s Start of Care date was found to be 03/19/24 with no documented aide supervision during services. Patient 5 Review of Patient 5’s Hospice Certification and Plan of Care for the certification period dated 06/04/24 to 08/02/24, revealed an order for hospice aide services for assistance with personal care two times per week. There were documented aide visits made on Tuesdays and Fridays throughout the episode, however, there were no documented aide supervisory visits by an RN performed during the episode. The patient’s Start of Care date was found to be 08/09/23 with no documented aide supervision during services. Patient 7 Review of Patient 7’s Hospice Certification and Plan of Care for the certification period dated 07/17/24 to 09/14/24, revealed an order for hospice aide services for assistance with personal care one time per week. There were documented aide visits weekly throughout the episode however, there were no documented aide supervisory visits by an RN performed during the episode. The patient’s Start of Care date was found to be 10/18/24 with no documented aide supervision during services. During an interview on 08/13/24 at 3:45 PM, Staff A, Administrator, confirmed the above finding of not performing aide supervisory visits and stated that they, “had not gotten back to doing that since COVID.””

“Based on review of hospice documentation and staff interview, it was determined the hospice failed to ensure that volunteers provided at least 5 percent of the total patient care and administrative service hours annually. This failed practice has the potential to affect quality of services for patients who request volunteer services. Findings Include: Review of agency volunteer information provided, included a form titled, “2023 Volunteer Analysis,” which showed the hours worked by hospice staff and volunteers for the year of 2023. Hours worked by hospice staff were confirmed to be 7166, while volunteer worked hours were 383. The agency had determined their annual percentage to be 5.3%. However, when the actual volunteer hours documented were reviewed, several hours were found to be while the hospice aide was actually in the home to provide ordered services and care for the patient. When the hours were refigured, without using the direct patient care hours by the hospice aide, the agency’s percentage fell below the 5 percent range. During an interview on 08/13/24 at 3:50 PM, Staff A, Administrator, confirmed being unaware that paying volunteers for hours of care provided to the patients was prohibited. Staff A confirmed inability to get volunteers, if they weren’t paid. The Administrator confirmed the above findings of agency volunteers not meeting 5 percent of the total patient care and administrative service hours annually.”