Anthem Hospice

“Based on record review and interview, the hospice failed to ensure bereavement care planning for seven (Patients #5, 7, 10, 17, 18, 19 and #20) of 20 patients. Findings: Patient #5A review of the clinical record showed an election of the hospice benefit on 08/25/25 with a completion of the initial spiritual and bereavement assessment on 08/26/25. A review of a POC dated 04/22/26 to 06/20/26 and IDG updates to the POC on 04/14/26 and on 04/28/26 showed no bereavement care plan and no bereavement interventions and goals included as a part of the overall POC. Patient #7A review of the clinical record showed an election of the hospice benefit on 08/19/25 with a completion of the initial spiritual and bereavement assessment on 08/19/25. A review of a POC dated 04/16/26 to 06/14/26 and IDG updates to the POC on 04/14/26 and on 04/28/26 showed no bereavement care plan and no bereavement interventions and goals included as a part of the overall POC. Patient #10A review of the clinical record showed an election of the hospice benefit on 03/18/26 with a completion of the initial spiritual and bereavement assessment on 03/19/25. A review of a POC dated 03/18/26 to 06/15/26 and IDG updates to the POC on 03/24/26, 04/07/26, 04/21/26 and on 05/05/26 showed no bereavement care plan and no bereavement interventions and goals included as a part of the overall POC. Patient #17A review of the clinical record showed an election of the hospice benefit on 11/15/25 with a completion of the initial spiritual and bereavement assessment on 11/17/25. A review of a POC dated 02/13/26 to 05/13/26 and IDG updates to the POC on 02/03/26, 02/17/26, 03/03/26, 03/10/26, 03/24/26 and on 04/07/26 showed no bereavement care plan and no bereavement interventions and goals included as a part of the overall POC. Patient #18A review of the clinical record showed an election of the hospice benefit on 11/18/25 with a completion of the initial spiritual and bereavement assessment on 11/18/25. A review of a POC dated 02/16/26 to 05/16/26 and IDG updates to the POC on 02/03/26, 02/17/26 and on 03/03/26 showed no bereavement care plan and no bereavement interventions and goals included as a part of the overall POC. Patient #19A review of the clinical record showed an election of the hospice benefit on 08/05/25 with a completion of the initial spiritual and bereavement assessment on 08/06/25. A review of a POC dated 11/03/25 to 01/31/26 and IDG updates to the POC on 11/04/25, 11/21/25, 12/02/25, 12/16/25 and on 12/23/25 showed no bereavement care plan and no bereavement interventions and goals included as a part of the overall POC. Patient #20A review of the clinical record showed an election of the hospice benefit on 11/13/25 with a completion of the initial spiritual and bereavement assessment on 11/13/25. A review of a POC dated 11/13/25 to 02/10/26 and IDG updates to the POC on 11/25/25 and on 12/19/25 showed no bereavement care plan and no bereavement interventions and goals included as a part of the overall POC. On 05/07/26 at 10:45 a.m. to 11:52 a.m., Staff A stated the Patients #5, 7, 10, 17, 18, 19 and #20 did not have bereavement care plans in place.”

“Based on record review and interview, the hospice failed to ensure plans of care: 1.Included interventions and goals for the hospice diagnosis for two (Patients #2 and #3) of 20 patients. 2.Were updated to meet patient care needs for one (Patients #19) of 20 patients. Findings: INTERVENTIONS Patient #2A review of a POC dated 04/13/26 to 06/11/26 with IDG updates on 04/14/26 and on 04/28/26 showed no SN service discipline interventions and goals for the hospice diagnosis of nutritional marasmus. The clinical record showed no communications between the IDG members related to the hospice diagnosis. On 05/07/26 at 10:35 a.m., Staff A stated the POC did not show SN interventions or goals for the hospice diagnosis. Patient #3A review of a POC dated 04/21/26 to 06/11/26 with IDG updates on 04/21/26 and on 05/05/26 showed no SN service discipline interventions and goals for the hospice diagnosis of unspecified protein calorie malnutrition. The clinical record showed no communications between the IDG members related to the hospice diagnosis. On 05/07/26 at 10:37 a.m., Staff A stated the POC did not show SN interventions or goals for the hospice diagnosis. UPDATED Patient #19A review of a POC dated 11/03/25 to 01/31/26 with IDG updates on 11/04/25, 11/21/25, 12/02/25, 12/16/25 and on 12/23/25 showed a SN service discipline visit frequency of one time a week. The clinical record showed SN visits were conducted for the weeks of:11/03/25 to 11/09/25 on 11/04/25 and 11/06/25 (one visit ordered, two visits conducted).11/10/25 to 11/16/25 on 11/11/25 and 11/13/25 (one visit ordered, two visits conducted).11/17/25 to 11/23/25 on 11/18/25 and 11/20/25 (one visit ordered, two visits conducted).12/01/25 to 12/07/25 on 12/02/25 and 12/04/25 (one visit ordered, two visits conducted).12/08/25 to 12/14/25 on 12/09/25, 12/11/25 and 12/13/25 (one visit ordered, three visits conducted). The clinical records showed no communications between the IDG members about the need to increase the SN visit frequency and showed no changes in the orders. On 05/07/26 at 10:37 a.m., Staff A stated the POC did not show an increase in the SN visits.”

“Based on record review and interview, the hospice failed to ensure QAPI PIPs reflected the needs of its patient population for all patients and employees. Findings: A review of QAPI program records showed no QAPI PIP activities, data or meeting minutes in the calendar year of 2024. A review of QAPI program records for first quarter 2025 on 04/29/25 showed no identification, data analysis or monitoring activities of a PIP. A review of QAPI program records for second quarter 2025 on 09/10/25 showed no identification, data analysis or monitoring activities of a PIP. A review of QAPI program records for third quarter 2025 on 10/14/25 showed no identification, data analysis or monitoring activities of a PIP. On 05/07/26 at 10:05 a.m., Staff B stated:1.The hospice was bought out at the end of 2024, and the previous owner did not give access to the QAPI records.2.There were no QAPI program records for calendar year 2024.3.There were no PIPs in place for calendar year 2025.”

“Based on record review and interview, the agency failed to ensure continued review and update of a hospice aide care plan for eight (Patients #2, 4, 5, 6, 8, 9, 11 and 19) of 20 patients. Findings: Patient #2A review of a POC dated 04/21/26 to 06/19/26 and IDG updates to the POC on 04/21/26 and on 05/05/26 which ordered hospice aide visits at a frequency of three times a week. The clinical record showed no such update to the hospice aide care plan and showed no update to the frequency of aide services since 02/20/26. On 05/07/26 at 10:35 a.m., Staff A stated the aide care plan was not reviewed or updated during the RN recertification visit. Patient #4A review of a POC dated 04/16/26 to 07/14/26 and IDG updates to the POC on 04/14/26 and on 04/28/26 which ordered hospice aide visits at a frequency of one time a week. The clinical record showed no update to the hospice aide care plan and showed no update to the frequency of aide services since 01/20/26. On 05/07/26 at 10:40 a.m., Staff A stated the aide care plan was not reviewed or updated during the RN recertification visit. Patient #5A review of a POC dated 04/22/26 to 06/20/26 and IDG updates to the POC on 04/14/26 and on 04/28/26 which ordered hospice aide visits at a frequency of one time a week. The clinical record showed no update to the hospice aide care plan and showed no update to the frequency of aide services since 02/16/26. On 05/07/26 at 10:45 a.m., Staff A stated the aide care plan was not reviewed or updated during the RN recertification visit. Patient #6A review of a POC dated 04/19/26 to 06/17/26 and IDG updates to the POC on 04/21/26 and on 05/05/26 which ordered hospice aide visits at a frequency of two times a week. The clinical record showed no update to the hospice aide care plan and showed no update of the frequency of aide services since 02/18/26. On 05/07/26 at 10:45 a.m., Staff A stated the aide care plan was not reviewed or updated during the RN recertification visit. Patient #8A review of a POC dated 04/17/26 to 06/15/26 and IDG updates to the POC on 04/14/26 and on 04/28/26 which ordered hospice aide visits at a frequency of three times a week. The clinical record showed no update to the hospice aide care plan and showed no update to the frequency of aide services since 02/20/26. On 05/07/26 at 10:45 a.m., Staff A stated the aide care plan was not reviewed or updated during the RN recertification visit. Patient #9A review of a POC dated 03/23/26 to 05/21/26 and IDG updates to the POC on 03/24/26, 04/07/26, 04/21/26 and on 05/05/26 which ordered hospice aide visits at a frequency of two times a week. The clinical record showed no update to the hospice aide care plan and showed no update to the frequency of aide services since 01/22/26. On 05/07/26 at 11:05 a.m., Staff A stated the aide care plan was not reviewed or updated during the RN recertification visit. Patient #11A review of a POC dated 04/06/26 to 06/04/26 and IDG updates to the POC on 03/31/26, 04/16/26 and on 04/28/26 which ordered hospice aide visits at a frequency of three times a week. The clinical record showed no update to the hospice aide care plan and showed no update to the frequency of aide services since 02/20/26. On 05/07/26 at 11:20 a.m., Staff A stated the aide care plan was not reviewed or updated during the RN recertification visit. Patient #19A review of a POC dated 11/03/25 to 01/31/26 and IDG updates to the POC on 11/04/25, 11/21/25, 12/02/25, 12/16/25 and on 12/23/25 which ordered hospice aide visits at a frequency of one time a week. The clinical record showed no update to the hospice aide care plan and showed no update to the frequency of aide services since 08/05/25. On 05/07/26 at 11:45 a.m., Staff A stated the aide care plan was not reviewed or updated during the RN recertification visit.”