Guardian Hospice Care, Inc.

“Based on review of clinical records (CR) and interviews with staff the agency failed to ensure staff followed the visit schedule as ordered for by the physician on the plan of care for one (1) of five (5) records reviewed. CR #4 Findings include: Review of agency policies on 11/7/24 at approximately 12:00PM and 11/8/24 at approximately 8AM revealed the following: Policy titled, “physician orders” stated, “Physician orders are obtained as needed...Some of the reasons orders are obtained from physician include, but are not limited to...change in visit frequency if not within the range specified in the patient’s plan of care...” Policy titled, “plan of care” stated, “The interdisciplinary written plan of care is based on initial and updated patient-specific comprehensive assessment by members of the IDG and is developed with measurable goals and outcomes for planned interventions...” A review of Clinical records completed 11/6/24 and 11/7/24, at approximately 10:00AM and revealed the following: CR #4: Start of Care (SOC): 8/2/24, Passed away on 10/17/24. Certification period reviewed: 8/2/24-10/30/24. Certification period contained order for Hospice Aides (2) times per week. During the following weeks 8/4/24-8/10/24 and 8/25/24-8/31/24 an additional hospice aide visit was conducted for a total of three (3) hospice aide visits each week. During the week of 9/1/24-9/7/24 two (2) additional hospice aide visits were conducted for a total of four (4) hospice aide visits that week. There were no orders or physician notification to change the frequency for the hospice aide visits. Interview with administrator on 11/8/24 at approximately 10:30AM confirmed the above findings.”

“Based on a review of personnel files (PF), agency policies, and an interview with the agency’s administrator it was determined that the agency failed to ensure a Pennsylvania State police criminal background check was conducted at hire for six (6) of seven (7) personnel files reviewed (PF #1, 3, 4, 5, 6, & 7). And agency failed to ensure an FBI criminal background check was conducted at hire for one (1) of seven (7) personnel files reviewed (PF#1). Findings Include: Agency policy reviewed on 11/7/24 at approximately 12:00PM and 11/8/24 at approximately 8:00 AM revealed the following: Policy titled, “Criminal Background Checks” stated, “It is the policy of this Agency that direct care staff members have a criminal history check in his/her personnel file within 30 days of hire and prior to independent home visits. The employee may start orientation but may not make home visits prior to the results of the check being returned...If an applicant has been a Pennsylvania resident for the past two years, only a state criminal check is required, otherwise both a state and federal check are required...” A review of PFs was conducted on 11/6/24 and 11/7/24 at approximately 10:00 AM and revealed the following: PF #1, Date of Hire: 9/26/24: File contained employment application that listed current address in New Jersey. Pennsylvania State Police criminal background check was completed on 11/7/24 which is after the first date of hire. There was no documentation of a Federal criminal check conducted. PF#3, Date of Hire: 7/23/24. Pennsylvania State Police criminal background check was completed on 11/7/24 which is after the first date of hire. PF#4, Date of Hire: 5/16/24. Pennsylvania State Police criminal background check was completed on 11/7/24 which is after the first date of hire. PF#5, Date of Hire: 6/12/24. Pennsylvania State Police criminal background check was completed on 11/7/24 which is after the first date of hire. PF#6, Date of Hire: 7/17/24. Pennsylvania State Police criminal background check was completed on 9/18/24 which is after the first date of hire. PF#7, Date of Hire: 5/17/24. Pennsylvania State Police criminal background check was completed on 11/7/24 which is after the first date of hire. An interview conducted with the agency’s administrator on 11/8/24 at approximately 10:30 AM. confirmed the above findings.”