Amity Hospice Care LLC

“Upon patient record review, 3 of 14 (Patients #3, 9, 10) did not have evidence that a Registered Nurse is designated to ensure continuous assessment of the patient and family’s needs and to coordinate activities with other members of the interdisciplinary group (IDG). The IDG must work together and is responsible for supervision of the care and service for each patient and family. Patient #3: During the SN visit on 06/30/26, the pain assessment states that there is ‘0’ pain, however, the narrative for the visit states that daughter is concerned as patient continuing to have pain in her right knee that is not controlled by Tylenol. MD ordered Tramadol. there was no evidence of a follow up call or visit for 7 days. Patient #9: On 05/01/26, patient received SN visit and was prescribed Augmentin as well as nebulizer treatments for signs and symptoms of respiratory infection. There is no evidence of a follow up call or visit for 4 days. On 07/16/26, patient was found to have insomnia, new medication of Trazadone started by MD. There is no evidence of a follow up call or nursing visit for 6 days. Patient #10: On 04/29/26, SN visit made and patient experiencing high BP. MD order received to increase Metoprolol to twice daily. There is no evidence of a follow up call or visit for 7 days. On 05/22/26, call received from spouse that patient is having nausea and higher blood pressure. SN visit revealed a BP of 180/110. The MD ordered Losartan, Clonidine as needed for HTN, and Zofran for nausea. There is no evidence of a follow up call or visit for 5 days.”

“Upon patient record review, 4 of 14 (Patient #1, 2, 5, 10) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient #1: The patient is using an oxygen concentrator as well as a nebulizer. There is no evidence of interventions or goals for use of oxygen or nebulizer in the plan of care. Patient #2: The patient has seizures. They are currently on Keppra and Vimpat. There is no evidence of interventions or goals related to seizures including precautions. The patient has a plan of care for Endocrine for type 2 diabetes. The patient has no evidence of a diagnosis of diabetes and there is no evidence of any treatment for diabetes. Patient #5: The patient is a full code. There is no evidence of interventions and goals for advanced care planning. Patient #10: The patient has history of depression and is on Celexa. There is no evidence of interventions or goals for depression. The patient is a full code. There is no evidence of interventions and goals for advanced care planning.”

“Upon personnel record review, 1 of 12 (Personnel #10 ) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: (This standard applies to all Hospice Aides providing care/service who are directly employed by the hospice or through a contractual agreement.) ·Communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other hospice staff. ·Reading and recording temperature, pulse, and respiration ·Safe transfer techniques and ambulation. ·Normal range of motion and positioning ·Appropriate and safe techniques in personal hygiene and grooming that include-- ·(A) Bed bath ·(B) Sponge, tub, and shower bath ·(C) Shampoo, sink, tub, and bed ·(D) Nail and skin care ·(E) Oral hygiene ·(F) Toileting and elimination The other subject areas in this section may be evaluated through written examination, oral examination or after observation of a Hospice Aide with a patient. Personnel #10: The orientation and annual competencies show that all tasks were completed verbally. There is no evidence of the required tasks above being completed with a patient or pseudo patient.”

“Upon patient client record review, 4 of 14 (Patients #1, 4, 6, 7) did not have evidence that each patient record contains: • Signed copies of the notice of patient rights in accordance with 418.52 • Signed election statement in accordance with 418.24 Patients #1, 7: The patient/caregiver signed that they requested a copy of the election addendum. There is no evidence in the record that the addendum was provided and signed by the patient/caregiver. Patients #4, 6: The record contains the hospice election addendum form but it is blank, there is no evidence that the patient/caregiver was given the opportunity to accept or decline the election addendum.”