Bristol Hospice-NW Louisiana

“It is required that each patient’s individualized written plan of care: identifies planned interventions based on problems identified in the initial and updated comprehensive assessments. This standard was not met as evidenced by clinical record review and interview. In 2 of 19 (11%) clinical records reviewed, the hospice did not ensure that the written plan of care included interventions based on problems identified in the comprehensive assessments. Clinical Record 3: The patient elected hospice care on 10/06/2023 with the diagnosis of Alzheimer’s Disease. The RN completed an initial assessment on 10/06/2023, documenting that the patient had edema in their right arm. The plan of care did not identify interventions for the edema. Clinical Record 14: The patient elected hospice care on 03/19/2023 with the diagnosis of CVA. The RN completed an initial assessment on 03/19/2023, documenting that the patient was an aspiration risk. The plan of care did not identify interventions for the aspiration risk. The Director of Clinical Services was interviewed on 03/13/2024 and confirmed that the plans of care did not include interventions and goals based on the problems identified in the initial assessment.”

“It is required that each patient’s individualized written plan of care: includes all services necessary for the palliation and management of the terminal illness, including the following: medical supplies and appliances necessary to meet the needs of the patient. This standard was not met as evidenced by clinical record review and interview. In 19 of 19 (100%) clinical records reviewed, the agency did not ensure that medical supplies related to the palliation and management of the patient’s terminal illness and related conditions were identified in the plan of care. Clinical Record 1: The patient elected hospice care on 12/02/2023 with the diagnosis of Alzheimer’s Disease. The initial assessment completed by the Registered Nurse (RN) on 12/02/2023, documenting that the patient was incontinent of bowel and bladder and wore briefs. The briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 2: The patient elected hospice care on 07/27/2023 with the diagnosis of Alzheimer’s Disease. The initial assessment completed by the RN on 07/27/2023, documenting that the patient was incontinent of bowel and bladder and wore briefs. The briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 3: The patient elected hospice care on 10/06/2023 with the diagnosis of Alzheimer’s Disease. The RN completed an initial assessment on 10/06/2023, documenting that the patient wore adult disposable underwear. The adult disposable underwear were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 4: The patient elected hospice care on 04/06/2023 with the diagnosis of Cerebral Ischemia. The RN completed an initial assessment on 04/06/2023, documenting that the patient was incontinent of bowel and bladder and wore briefs. The briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 5: The patient elected hospice care on 03/10/2023 with the diagnoses of chronic obstructive pulmonary disease (COPD) and respiratory infection. The RN completed an initial assessment on 03/10/2023, documenting that the patient wore pull-ups. The pull-ups were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 6: The patient elected hospice care on 08/17/2023 with the diagnoses of COPD and respiratory infection. The RN completed an initial assessment on 08/17/2023, documenting that the patient wore adult briefs. The adult briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 7: The patient elected hospice care on 05/24/2023 with the diagnosis of Cerebral Vascular Accident (CVA). The RN completed an initial assessment on 05/24/2023, documenting that the patient was incontinent of bowel and bladder and the patient wears depends. The depends were not documented in the plan of care dated 12/01/2023 as of the review on 03/12/2024. Clinical Record 8: The patient elected hospice care on 01/19/2023 with the diagnosis of Heart Disease. The RN completed an initial assessment on 01/19/2023, documenting that the patient wore adult briefs. The adult briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 9: The patient elected hospice care on 12/08/2023 with the diagnoses of Malignant Neoplasm Prostate and Wounds. The RN completed an initial assessment on 12/08/2023, documenting that the patient wore adult briefs. The adult briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 10: The patient elected hospice care on 10/24/2023, with the diagnosis of COPD with acute exacerbation. The RN completed an initial assessment on 10/24/2023, documenting that the patient wore adult briefs. The adult briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 11: The patient elected hospice care on 09/06/2023 with the diagnosis of Malignant Neoplasm of Unspecified part of bronchus. The RN completed an initial assessment on 09/06/2023, documenting that the patient wore adult briefs. The adult briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 12: The patient elected hospice care on 03/22/2023 with the diagnosis of Heart Disease. The RN completed an initial assessment on 03/22/2023, documenting that the patient wore adult disposable briefs. The adult disposable briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 13: The patient elected hospice care on 11/18/2022 with the diagnosis CVA. The RN completed an initial assessment on 11/18/2022, documenting that the patient wore adult disposable briefs. The adult disposable briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 14: The patient elected hospice care on 03/19/2023 with a diagnosis of CVA. The RN completed an initial assessment on 03/19/2023, documenting that the patient wore adult briefs. The adult briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 15: The patient elected hospice care on 06/01/2023 with the diagnoses Unspecified Severe Protein Calorie Malnutrition and Multiple Wounds. The RN completed an initial assessment on 06/01/2023, documenting that the patient wore adult briefs. No supplies were documented in the plan of care as of the review on 03/12/2024. Clinical Record 16: The patient elected hospice care on 06/01/2023 with the diagnosis of End-Stage Heart Failure. The RN completed an initial assessment on 06/01/2023, documenting that the patient was incontinent of bowel and bladder and wore adult briefs. The adult briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 17: The patient elected hospice care on 01/29/2023 with the diagnosis of Parkinsonism. The RN completed an initial assessment on 01/29/2023, documenting that the patient wears adult disposable briefs. The adult disposable briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 18: The patient elected hospice care on 11/28/2023 with the diagnosis of Alzheimer’s Disease. The RN completed an initial assessment on 11/28/2023, documenting that the patient wore adult disposable briefs. The adult disposable briefs were not documented in the plan of care as of the review on 03/12/2024. Clinical Record 19: The patient elected hospice care on 02/03/2024 with the diagnosis of Malignant Neoplasm of Upper Lobe R Bronchus. The RN completed an initial assessment on 02/03/2024, documenting that the patient was incontinent of bowel and bladder and wore adult disposable briefs. The adult disposable briefs were not documented in the plan of care as of the review on 03/12/2024. The Director of Patient care Services was interviewed on 03/12/2024 and confirmed that the supplies related to the palliation and management of the patient’s terminal illness and related conditions were not identified in the plan of care.”