Integris Hospice House

“Based on record review and interview, the hospice failed to ensure the initial psychosocial assessment was conducted within the five-day timeframe required to complete the initial comprehensive assessment for one (Patient #10) of 19 patients. Findings: Patient #10A review of the clinical record showed an election of the hospice benefit/SOC on 01/08/25. Documentation showed a psychosocial assessment was conducted on 01/17/25 (9 days later) by an MSW. Documentation showed no declined MSW visits, no physician notifications, and no changes in orders. On 08/22/25 at 11:00 a.m., Staff A stated the MSW did not conduct the initial psychosocial assessment within the five-day timeframe.”

“Based on record review and interview, the hospice failed to ensure a bereavement care plan was initiated or was included as a part of the overall POC after the initial and ongoing spiritual/bereavement assessments for 15 (Patients #7, 8, 9, 12, 13, 14 and #15) of 19 patients. Findings: Patient #7A review of the clinical record showed an election of the hospice benefit on 06/28/25 and completion of the bereavement assessment on 07/02/25. A review of a POC dated 06/28/25 to 09/25/25 and IDG updates to the POC on 06/28/25, 07/04/25, 07/18/25, 08/01/25 and on 08/15/25 showed no bereavement care plan and/or no bereavement interventions and goals included as a part of the overall POC. Documentation showed no change in orders. On 08/22/25 at 10:55 a.m., Staff A stated the patient had no BCP or bereavement interventions and goals included as a part of the POC. Patient #8A review of the clinical record showed an election of the hospice benefit on 01/20/25 and completion of the bereavement assessment on 01/21/25. A review of a POC dated 07/20/25 to 09/17/25 and IDG updates to the POC on 08/15/25 showed no bereavement care plan and/or no bereavement interventions and goals included as a part of the overall POC. Documentation showed no change in orders. On 08/22/25 at 10:57 a.m., Staff A stated the patient had no BCP or bereavement interventions and goals included as a part of the POC. Patient #9A review of the clinical record showed an election of the hospice benefit on 05/07/25 and completion of the bereavement assessment on 05/09/25. A review of a POC dated 05/07/25 to 09/25/25 and IDG updates to the POC on 05/09/25, 05/23/25, 06/06/25, 06/20/25, 07/04/25, 07/18/25 and on 08/01/25 showed no bereavement care plan and/or no bereavement interventions and goals included as a part of the overall POC. Documentation showed no change in orders. On 08/22/25 at 10:58 a.m., Staff A stated the patient had no BCP or bereavement interventions and goals included as a part of the POC. Patient #12A review of the clinical record showed an election of the hospice benefit on 05/09/25 and completion of the bereavement assessment on 05/12/25. A review of a POC dated 08/07/25 to 11/04/25 and IDG updates to the POC on 08/01/25 showed no bereavement care plan and/or no bereavement interventions and goals included as a part of the overall POC. Documentation showed no change in orders. On 08/22/25 at 11:07 a.m., Staff A stated the patient had no BCP or bereavement interventions and goals included as a part of the POC. Patient #13A review of the clinical record showed an election of the hospice benefit on 05/18/25 and completion of the bereavement assessment on 05/20/25. A review of a POC dated 05/18/25 to 08/16/25 and IDG updates to the POC on 05/09/25, 05/30/25, 06/13/25, 06/27/25, 07/11/25, 07/25/25 and on 08/08/25 showed no bereavement care plan and/or no bereavement interventions and goals included as a part of the overall POC. Documentation showed no change in orders. On 08/22/25 at 11:10 a.m., Staff A stated the patient had no BCP or bereavement interventions and goals included as a part of the POC. Patient #14A review of the clinical record showed an election of the hospice benefit on 11/22/24 and completion of the bereavement assessment on 11/26/24. A review of a POC dated 07/20/25 to 09/17/25 and IDG updates to the POC on 07/11/25, 07/25/25 and on 08/08/25 showed no bereavement care plan and/or no bereavement interventions and goals included as a part of the overall POC. Documentation showed no change in orders. On 08/22/25 at 11:12 a.m., Staff A stated the patient had no BCP or bereavement interventions and goals included as a part of the POC. Patient #15A review of the clinical record showed an election of the hospice benefit on 02/14/24 and completion of the bereavement assessment on 02/16/24. A review of a POC dated 05/30/25 to 07/28/25 and IDG updates to the POC on 05/16/25, 05/30/25, 06/13/25, 06/27/25 and on 07/11/25showed no bereavement care plan and/or no bereavement interventions and goals included as a part of the overall POC. Documentation showed no change in orders. On 08/20/25 at 2:20 p.m., Staff A stated the patient had no BCP or bereavement interventions and goals included as a part of the POC.”

“Based on record review and interview, the hospice failed to ensure:1. Aide services were provided in accordance with the plan of care for three (Patients #5, 12 and #15) of 19 patients.2. Skilled nurse services were provided in accordance with the plan of care for seven (Patients #9 and #15) of 19 patients. Findings: Patient #5A review of the plan of care dated 06/26/25 to 09/23/25 and plan of care updates dated 06/27/25, 07/11/25, 07/25/25 and 08/08/25 ordered aide visits at a frequency of three times a week, effective week of 07/06/25. The clinical record showed during the weeks of 08/04/25 to 08/10/25 aide visits were conducted on 08/04/25 and 08/06/25 (three visits ordered, two visits conducted). The clinical record showed no patient or family refusal of visits and no changes in the ordered frequency for the aide. On 08/22/25 at 10:50 a.m., Staff A stated the record only showed two aide visits were made that week. Patient #9A review of the plan of care dated 05/07/25 to 08/04/25 and plan of care updates dated 05/09/25, 05/23/25, 06/06/25, 06/20/25, 07/04/25, 07/18/25 and 08/01/25 ordered SN visits at a frequency of one to two times a week, effective week of 05/07/25. The clinical record showed during the weeks of 05/18/25 to 05/24/25 no SN visits were conducted (one to two visits ordered, no visits conducted), 06/15/25 to 06/21/25 no SN visits were conducted (one to two visits ordered, no visits conducted), 06/29/25 to 07/05/25 no SN visits were conducted (one to two visits ordered, no visits conducted), 07/15/25 to 07/20/25 no SN visits were conducted (one to two visits ordered, no visits conducted) and 07/27/25 to 08/02/25 no SN visits were conducted (one to two visits ordered, no visits conducted). The clinical record showed no patient or family refusal of visits and no changes in the ordered frequency for the SN. On 08/22/25 at 10:58 a.m., Staff A stated the record did not show SN visits were made during those weeks. Patient #12A review of the plan of care dated 08/07/25 to 11/04/25 and plan of care update dated 08/01/25 ordered aide visits at a frequency of three times a week, effective week of 08/07/25. The clinical record showed during the week of 08/07/25 to 08/16/25 aide visits were conducted on 08/12/25 and 08/14/25 (three visits ordered, two visits conducted). The clinical record showed no patient or family refusal of visits and no changes in the ordered frequency for the aide. On 08/22/25 at 11:07 a.m., Staff A stated the record only showed two aide visits were made that week. Patient #15A review of the plan of care dated 05/30/25 to 07/28/25 and plan of care updates dated 05/16/25, 05/30/25, 06/13/25, 06/27/25 and 07/11/25 ordered aide visits at a frequency of three times a week, effective week of 06/27/25. The clinical record showed during the week of 06/29/25 to 07/05/25 aide visits were conducted on 06/30/25 and 07/02/25 (three visits ordered, two visits conducted). The clinical record showed no patient or family refusal of visits and no changes in the ordered frequency for the aide. On 08/22/25 at 11:14 a.m., Staff A stated the record only showed two aide visits were made that week.”

“Based on record review and interview, the agency failed to ensure care was coordinated between the IDG members and the physician for one (Patient #18) of 19 patients. Findings: Patient #19A review of the POC dated 12/31/24 to 03/08/25 and plan of care updates dated 12/31/24, 01/03/25, 01/17/25, 01/31/25, 02/14/25 and 02/28/25 showed orders for an aide visit frequency and duration of three times a week for 14 weeks. The clinical record showed between 01/01/25 to 03/07/25 aide visits were missed on 01/01/25, 01/03/25, 01/08/25, 01/13/25, 01/17/25, 01/20/25, 01/22/25, 01/24/25, 01/27/25, 01/29/25, 01/31/25, 02/03/25, 02/12/25, 02/14/25, 02/17/25, 02/19/25, 02/24/25, 02/26/25, 02/28/25, 03/04/25 and on 03/07/25 (30 visits ordered, 6 visits conducted). The clinical record showed no discussion of aide missed visits by the IDG, patient or family refusal of visits and showed no changes in the ordered visit frequency for the aide. On 08/22/25 at 11:20 a.m., Staff A stated the IDG did not discuss the aide missed visits or update the patient’s POC.”

“Based on record review and interview, the agency failed to ensure required background checks were completed for one (Volunteer #3) of three volunteers reviewed. Findings: The “Long-Term Care Security Act Title 63 of the Oklahoma Statutes” documented requirement for an OKSCREEN national background check with fingerprinting for all employees of a home care agency whose employment began after 07/01/14. Volunteer #3A review of the personnel record showed no documentation of a background check through OKSCREEN for employment that began 07/22/25. On 08/22/25 at 9:00 a.m., Staff D stated Volunteer #3 had no background check through OkScreen.”