Abundant Hospice Services LLC

“Based on observation, record review, and interview, the interdisciplinary group (core group of a physician, registered nurse, chaplain, and social worker that provided/supervised all care and services, ensuring a holistic approach to terminal illness and bereavement) failed to include in the plan of care, medical supplies or appliances in 3 (Patient #3, Patient #4, and Patient #6) of 14 patient records reviewed. The failure placed the patients at risk of receiving care that was inappropriate and did not meet the patients’ specific needs. Patient #3:Record review of Patient #3’s clinical record revealed a Plan of Care dated 2/6/2026 to 5/6/2026. The Plan of Care listed Chronic Systolic (congestive) Heart Failure (heart muscle becomes too weak or stiff to pump blood efficiently) as the terminal diagnosis. The Plan of Care did not list the durable medical equipment and supplies necessary to meet Patient #3 needs. Review of documentation by Registered Nurse C of an initial comprehensive assessment conducted on 2/6/2026 indicated: Registered Nurse C identified that Patient #3 required grab bars and a walker. Registered Nurse C identified that a wound cleanser (liquid solution used to gently rinse away dirt, bacteria, cellular debris, and old drainage from a wound surface and its surrounding skin), Hydrofera blue (antibacterial foam wound dressing used to manage infection, absorb fluid, and promote healing in acute and chronic wounds), abdominal pads (an extra-thick, highly absorbent dressing used to cover and manage large, heavily draining wounds), kerlix (woven gauze bandage roll used to cushion, protect, and absorb drainage from wounds), and elastic bandages (stretchy, woven strip of cloth used to wrap around a body part to provide gentle, even pressure) needed for wound care to Patient #3’s left lower leg wound. The interdisciplinary group failed to include grab bars, walker, wound cleanser, Hydrofera blue, abdominal pads, kerlix, and elastic bandages in Patient #3’s Plan of Care. Patient #4:Record review of Patient #4’s clinical record revealed an Initial Plan of Care dated 9/13/2026 to 12/11/2026. The Plan of Care listed Senile Degeneration of the Brain (loss of thinking abilities, such as memory, attention, and reasoning) as the terminal diagnosis. The Plan of Care did not list the durable medical equipment and supplies necessary to meet Patient #4’s needs. Review of documentation by Registered Nurse C of an initial comprehensive assessment conducted on 2/6/2026 indicated: Registered Nurse C identified that Patient #4 required a gerichair (large, heavily padded medical recliner mounted on wheeled casters, designed to safely support older adults or individuals with limited mobility who spend extended periods sitting), hospital bed, overbed table, oxygen concentrator (medical device that takes in room air, filters out nitrogen, and delivers purified oxygen to people who have trouble breathing), and a portable oxygen tank. Observation at a home visit to Patient #4 conducted on 9/22/2026 at 10:45 AM, the Surveyor observed nursing facility staff transfer Patient #4 via mechanical life to a gerichair. The Surveyor observed an oxygen tank, oxygen concentrator, hospital bed, and overbed table in Patient #4’s room. The interdisciplinary group failed to include gerichair, hospital bed, overbed table, oxygen concentrator, mechanical lift, and oxygen portable in Patient #4’s Plan of Care. Patient #6:Record review of Patient #6’s clinical record revealed a Plan of Care dated 6/26/2026 to 9/23/2026. The Plan of Care listed Malignant Neoplasm of left Kidney (an abnormal growth of tissue in one of a pair of organs in the body that cleans the blood and makes urine) as the terminal diagnosis. The Plan of Care did not list the durable medical equipment and supplies necessary to meet Patient #4’s needs. Review of the documentation by Registered Nurse C of an initial comprehensive assessment conducted on 6/26/2026 indicated: Registered Nurse C identified that Patient #6 required grab bars, cane, oxygen concentrator, portable oxygen tank, and a walker. Review of physician orders indicated a physician order for an oxygen concentrator and portable oxygen tank. The interdisciplinary group failed to include grab bars, cane, and walker in Patient #6’s Plan of Care. During an interview on 9/23/2026 at 10:39 AM with the Administrator, Alternate Administrator, Supervising Nurse, and Registered Nurse C, the Surveyor discussed that the plans of care for Patient #3, Patient #4, and Patient #6 did not include the medical supplies and appliances necessary to meet the needs of the patients. The Surveyor asked why the plans of care did not include medical supplies and appliances. The Supervising Nurse and Registered Nurse C informed the Surveyor that they did not pull over to the plan of care from the initial comprehensive assessment. The Surveyor asked how the Interdisciplinary group reviewed the plan of care. The Supervising Nurse stated, “The interdisciplinary meeting is held, some staff attend on the phone.” The Supervising Nurse informed the surveyor that the admitting nurse would indicate in the initial comprehensive assessment what equipment and supplies the clients need; The selections then will be pulled to the plan of care. The Surveyor showed the Supervising Nurse the plans of care for Patient #3, Patient #4, and Patient #6 did not include equipment or supplies. The Surveyor asked how this could affect the patients. The Administrator and Supervising Nurse informed the Surveyor that it could affect patient safety. Review of the agency’s policy titled “Plan of Care Process PC.30,” last reviewed on 3/16/2026 read in part: “Purpose To ensure that the care provided is in accordance with the written Plan of Care (POC), appropriately planned, and delivered in a timely manner to meet the patient’s and family’s needs. Policy I. All Hospice care and services furnished to patients and their families will follow an individualized written POC established by the Hospice Interdisciplinary Group/Team (IDG/IDT) in collaboration with the Attending Physician (if any), the patient or representative, and the primary caregiver, if any of them so desire, and in accordance with the patient’s needs. II. The Hospice will develop an individualized written POC for each patient. The POC must reflect patient and family goals and interventions based on the problems identified in the initial comprehensive and updated comprehensive assessments...Procedure I. Information gathered from the initial assessment and be used by the Hospice to develop the Initial Plan of Care (IPOC)/Physicians Orders and to provide care and services to treat a patient and patient’s family’s immediate care and support needs... VI. The POC includes, but is not limited to...E. Medical supplies, equipment, and appliances necessary to meet the needs of the patient...””