Choice Health at Home - Oklahoma City Hospice

“Based on record review and interview, the hospice failed to ensure completion of the initial spiritual assessment no later than 5 calendar days after the election of hospice care for two (Patients #5 and 14) of 14 patients. Findings:Patient #5A review of the clinical record showed an election of the hospice benefit on 05/06/25 with no completion (in person) of the initial bereavement and spiritual assessment from 05/06/25 to 05/21/25 (15 days after the election of the hospice benefit). A review of the clinical record showed an initial spiritual assessment dated 05/08/25 was completed by telephone. Documentation showed no patient or caregiver refusal of an in person initial spiritual assessment.Patient #14A review of the clinical record showed an election of the hospice benefit on 01/17/25 with no completion (in person) of the initial bereavement and spiritual assessment from 01/17/25 to 01/31/25 (14 days after the election of the hospice benefit). A review of the clinical record showed an initial spiritual assessment dated 01/21/25 was completed by telephone. Documentation showed no patient or caregiver refusal of an in person initial spiritual assessment.On 05/21/25 at 1:15 pm., Staff B stated: the initial comprehensive assessment was to be completed within five days of the election of the hospice benefit and the initial spiritual assessment for Patients #5 and 14 was not completed in person within the first five days of the election of the hospice benefit. Staff B stated the Chaplain may have not been aware telehealth visits were no longer acceptable.”

“Based on record review and interview, the hospice failed to ensure1. Chaplain visits were provided in accordance with the plan of care for one (Patient #6) of 14 patients and2. hospice aide visits were provided in accordance with the plan of care for one (Patient #10) of 14 patients. Findings:Patient #6A review of the plan of care dated 03/01/25 to 04/29/25 showed a Chaplain frequency of two visits per month for two months. A review of the clinical record showed the following:A Chaplain visit note dated 03/07/25 showed the visit was completed by telephone.A Chaplain visit note dated 04/11/25 showed the visit was completed by telephone.A Chaplain visit note dated 04/18/25 showed the visit was completed by telephone.A Chaplain visit note dated 04/25/25 showed the visit was completed by telephone.Patient #10A review of the plan of care dated 03/12/25 to 05/10/25 showed a hospice aide frequency of three visits per week for one week and five visits per week for eight weeks. A review of the clinical record showed the following:Hospice aide visits dated 03/17/25, 03/18/25, 03/20/25 and a hospice aide missed visit note (no reason charted) for the week of 03/16/25 to 03/22/25 (three of five ordered visits completed). Documentation showed no patient/caregiver refusal of the visits, no attempt to reschedule the missed visit and no physician orders to change the ordered frequency.Hospice aide visits dated 04/07/25, and 04/08/25 for the week of 04/06/25 to 04/12/25 (two of five ordered visits completed). Documentation showed no patient/caregiver refusal of the visits and no physician orders to change the ordered frequency.Hospice aide visits dated 04/15/25, 04/17/25, 04/18/25 and a hospice aide missed visit note dated 04/16/25 (due to being out on paid time off and their grandfather falling) for the week of 04/13/25 to 04/19/25 (three of five ordered visits completed). Documentation showed no patient/caregiver refusal of the visits, no attempt to reschedule the missed visit and no physician orders to change the ordered frequency.Hospice aide visits dated 04/28/25, 04/29/25, 05/01/25 and 05/02/25 for the week of 04/27/25 to 05/03/25 (four of five ordered visits completed). Documentation showed no patient/caregiver refusal of the visits and no physician orders to change the ordered frequency.On 05/21/25 at 1:10 pm., Staff B stated:1. the Chaplain frequency was not followed as ordered for Patient #6 due to the Chaplain not being aware telehealth visits were no longer allowed and2. the hospice aide frequency was not followed as ordered for Patient #10.”

“Based on record review and interview, the hospice failed to ensure hospice aides reported missed/incomplete visits for one (Patient #10) of 14 patients. Findings:Patient #10A review of the plan of care dated 03/12/25 to 05/10/25 showed a hospice aide frequency of three visits per week for one week and five visits per week for eight weeks. A review of the clinical record showed the following:Hospice aide visits dated 03/17/25, 03/18/25, 03/20/25 and a hospice aide missed visit note (no reason charted) for the week of 03/16/25 to 03/22/25 (three of five ordered visits completed). Documentation showed no notification to the supervising nurse of the missed or incomplete visits.Hospice aide visits dated 04/07/25, and 04/08/25 for the week of 04/06/25 to 04/12/25 (two of five ordered visits completed). Documentation showed no notification to the supervising nurse of the incomplete visits.Hospice aide visits dated 04/15/25, 04/17/25, 04/18/25 and a hospice aide missed visit note dated 04/16/25 (due to being out on paid time off and their grandfather falling) for the week of 04/13/25 to 04/19/25 (three of five ordered visits completed). Documentation showed no notification to the supervising nurse of the missed or incomplete visits.Hospice aide visits dated 04/28/25, 04/29/25, 05/01/25 and 05/02/25 for the week of 04/27/25 to 05/03/25 (four of five ordered visits completed). Documentation showed no notification to the supervising nurse of the incomplete visits.On 05/21/25 at 1:10 pm., Staff B stated there was no documentation of the hospice aide notifying the supervising nurse of missed or incomplete visits for Patient #10.”