Precious Hearts Health Care Providers LLC

“Upon patient record review, 5 of 14 (Patients # 5, 9, 11, 12, 13) did not have evidence the plan of care must includes all services necessary for the palliation and management of the terminal illness and related conditions, including the following: • A detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs • The IDG demonstrates a proactive approach in developing each patient’s plan of care by planning ahead for anticipated patient changes and needs. Decisions should reflect the patient/family preferences rather than be solely a response to a crisis. Patient # 5: The patient’s plan of care from 8/29/25 contained orders for Nurse 3 PRN, MSW and SC 1 PRN. A discipline’s ordered visit frequency cannot include a PRN visit frequency without a baseline frequency to support it and must include the number of PRN. Patient # 9: The patient’s plan of care from 5/8/26 contained orders for Nurse 3 PRN. A discipline’s ordered visit frequency cannot include a PRN visit frequency without a baseline frequency to support it and must include the number of PRN. Patient # 11: The patient’s plan of care from 9/12/25 contained orders for Nurse 3 PRN, MSW and SC 1 PRN. A discipline’s ordered visit frequency cannot include a PRN visit frequency without a baseline frequency to support it and must include the number of PRN. Patient # 12: The patient’s plan of care from 7/17/25 contained orders for Nurse 3 PRN, and SC 1 PRN. A discipline’s ordered visit frequency cannot include a PRN visit frequency without a baseline frequency to support it and must include the number of PRN. Patient # 13: The patient’s plan of care from 5/8/26 contained orders for Nurse 3 PRN, and MSW 1 PRN. A discipline’s ordered visit frequency cannot include a PRN visit frequency without a baseline frequency to support it and must include the number of PRN.”

“Upon client record review, 4 of 14 (Patients # 2, 3, 4, 6) did not have evidence that the IDG in collaboration with the attending physician reviewed, revised and documents the individualized plan as frequently as the patient’s condition requires but no less frequently then every 15 calendar days. Patients # 2, 3, 4: The IDG minutes for 5/8/26, 5/22/26, 6/5/26, 6/16/26, 7/3/26, and 7/17/26 did not contain evidence of the nurses’ signature on the meeting attendance sign in page. The nurse was actively involved with the patient therefore there was no evidence of collaboration since there was no signature to validate participation. Patient # 6: The IDG minutes for 5/8/26, 5/22/26, and 6/5/26 did not contain evidence of the nurse’s signature on the meeting attendance sign in page. The nurse was actively involved with the patient therefore there was no evidence of collaboration since there was no signature to validate participation.”

“Upon personnel record review, 1 of 12 (Personnel # 8) 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 # 8: The hospice aide’s file did not contain evidence of an initial skills assessment for communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other hospice staff. The hospice aide’s file did not contain evidence of an annual skills assessment for a) communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other hospice staff, b) safe transfer techniques and ambulation, c) normal range of motion and positioning, d) appropriate and safe techniques in personal hygiene and grooming that include bed bath, sponge, tub and shower bath, nail and skin care, oral hygiene, and toileting and elimination.”

“Upon patient record review 1 of 14 (Patient # 5) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training The hospice aide’s latest plan of care dated 1/18/25 contained orders to record the date of last bowel movements each visit. The patient’s aide notes did not contain evidence of the date of bowel movements being recorded on 9/10/25, 9/11/25. 9/12/26. This portion of the aide note was left blank.”