Chi Health at Home

“Based on interview and document review, the agency failed to ensure services were provided in accordance with the plan of care (POC) for 2 of 2 patients (P6, P9) reviewed for volunteer services planned. P6’s plan of care (POC) dated 11/22/23 through 2/19/24, identified a start of care (SOC) date 11/22/23, with diagnosis of chronic obstructive pulmonary disease. The POC identified planned visits for services with visit sets, which included home health aide (HHA) one visit a week for 12 weeks, medical social work (MSW) visits two visits month for three months, one visit a month for one month and three as needed (prn), and skilled nursing visits one visit a week for two weeks, then two visits per week for ten weeks, one visit a week for one week, and five prn. P6’s physician order with POC update dated 11/28/23, identified a volunteer plan of care would be established based on the needs of P6 and their caregiver. The order did not identify how often the volunteer would visit or the duration of visits to be made. P6’s Visit Note Report dated 11/28/23, identified a (MSW) visit had been conducted and indicated hospice volunteer visits would begin and the first visit had been scheduled 12/1/23. P6’s medical record lacked orders for the frequency and duration the volunteer was to conduct visits as well as interventions to be performed during their visits. P6’s medical record also lacked documentation that any volunteer visits had been conducted or that the physician had been notified of the delay to start volunteer visits. P9’s POC dated 9/18/23 through 12/16/23, identified a SOC date 9/18/23, with diagnosis of heart disease and heart failure. The POC identified planned visits for services with visit sets, which included HHA one visit per week for 12 weeks, MSW two visits per month for three months, one visit per month for one month and 3 prn, chaplain one visit per month for one month, two visits per month for one month, three visits per month for one month, one visit per month for one month and three prn, and skilled nursing visits two visits per week for 13 weeks plus 5 prn. P9’s physician order with POC update dated 11/3/23, identified a volunteer plan of care would be established based on the needs of P9 and their caregiver. The order did not identify how often the volunteer would visit or the duration of visits to be made. P9’s Visit Note Report dated 11/3/23, identified a MSW visit had been conducted and indicated hospice volunteer visits would begin, with the first visit to start the following week. P9’s Volunteer Patient Contact Progress Notes identified volunteer visits had been conducted on 11/22/23, 11/30/23, 12/6/23, and 12/14/23. P9’s medical record lacked orders for the frequency and duration the volunteer was to conduct visits as well as interventions to be performed during their visits. During interview on 12/19/23, at 11:10 a.m. the medical social worker (MSW) stated she obtained an order when a volunteer was initiated, however, did not plot their visits on the POC calendar and so frequency and duration of visits did not pull to the patient’s POC. It was a flaw in the agency’s computer system they used. They would have to figure out a way to include this information in the patient’s POC. The information would be important to include as it was a service the agency was providing in the patient’s home. When interviewed on 12/20/23, at 9:00 a.m. the hospice clinical manager (CM)-A stated P6’s volunteer had been scheduled 12/1/23, but had called in sick and had not been replaced. A volunteer had been planned the next week but was not completed as P6 had been hospitalized. CM-A verified volunteer services were not included on the patient’s plan of care and orders for the volunteer frequency and duration of visits had not been obtained. It was not the agency’s practice to include the volunteer services on the POC as their computer program made it difficult to do so. It would be important to have the volunteer services included on each patient’s POC so all staff would know when a volunteer was going into the home. The agency’s policy Volunteer Program-Hospice with review date 8/30/23, identified the hospice agency recognized the volunteer as an important member of the the hospice team. The agency could use volunteers in direct client care services and all volunteers were considered employees of the hospice agency. The agency policy Volunteer Services with review date 2/17/22, identified purpose was to provide qualified volunteers to help meet the patient’s needs and to follow the Interdisciplinary Group Plan of Care. The hospice volunteer coordinator would arrange for volunteers to provide volunteer support to the patient, caregiver and/or family, according to the POC.”