Providence at Home With Compassus, Snohomish County

“Based on record review and interview, the agency failed to follow the plan of care (POC) relative to hospice aides (HA) visit frequencies and failed to notify the patient and/or their representatives of HA missed visits for 14 of 42 patients (Patient #119, Patient #128, Patient #130, Patient #131, Patient #132, Patient #133, Patient #134, Patient #135, Patient #137, Patient #138, Patient #139, Patient #140, Patient #141, and Patient #142). Failure to follow the POC and communicate with the patient and/or their representatives of changes to the POC may potentially have a clinical impact on the patients wellbeing. Findings included: 1. Document review of the agencys policy titled, “;Plan of Care”, (Date Revision: 07/2023) showed that the POC specifies the hospice care and services necessary to meet the patient and family-specific needs. 2. Record review of patient records for 14 of 42 patients (Patient #119, Patient #128, Patient #130, Patient #131, Patient #132, Patient #133, Patient #134, Patient #135, Patient #137, Patient #138, Patient #139, Patient #140, Patient #141, and Patient #142) showed: a. Patient #119s election date was on 07/11/24. Hospice aide (HA) services were ordered with frequencies of 1 visit every week for 12 weeks starting 07/14/24. On 07/24/24, a missed visit note showed visit discrepancy. There was no other documentation to show that the HA missed visit was communicated to the patient and/or their representative. b. Patient #128s election date was 07/08/20. HA services were ordered with frequencies of 2 visits every week for 5 weeks starting 07/07/20. The records showed the following HA missed visit showed: i. On 07/30/20, a missed visit note showed visit was declined. ii. On 09/03/24, a missed visit note showed visit was declined. There was no other documentation to show who declined the missed visits and that the HA missed visits were communicated to the patient and/or their representative. c. Patient #130s election date was 12/16/23. HA services were ordered with frequencies of 1 visit every week for 8 weeks starting 08/11/23. On 07/02/23, a missed visit note showed a missed HA visit. There was no other documentation to show that the HA missed visit was communicated to the patient and/or their representative. d. Patient #131s election date was 08/27/24. HA services were ordered with frequencies of 1 visit every week for 13 weeks starting 08/27/24. On 09/06/24, a missed visit note showed scheduling conflict, visit not made. There was no other documentation to show the HA missed visit was communicated to the patient and/or their representative. e. Patient #132s election date was 07/30/24. HA services were ordered with frequencies of 1 visit every week for 10 weeks starting 08/18/24. The record showed the following missed visits: i. On 08/27/24, a missed visit note showed scheduling conflict, visit was not made. ii. On 09/03/24, a missed visit note showed scheduling conflict. There was no other documentation to show the HA missed visits were communicated to the patient and/or their representative. f. Patient #133s election date was 07/01/24. HA services were ordered with frequencies of 1 visit every week for 12 weeks starting 07/02/24. On 08/02/24, a missed visit note showed regular hospice aide day off. There was no other documentation to show the HA missed visit was communicated to the patient and/or their representative. g. Patient #134s election date was 06/09/24. HA services were ordered with frequencies of 1 visit every week for 12 weeks starting 06/10/24. On 07/24/24, a missed visit note showed visit discrepancy. There was no other documentation to show the HA missed visit was communicated to the patient and/or their representative. h. Patient #135s election date was 06/13/24. HA services were ordered with frequencies of 1 visit every week for 13 weeks starting 06/14/24. The record showed the following missed visits: i. On 07/25/24, a missed visit note showed visit discrepancy. ii. On 08/26/24, a missed visit note showed visit discrepancy. iii. On 09/06/24, a missed visit note showed visit discrepancy. iv. On 09/11/24, a missed visit note showed scheduling conflict There was no other documentation to show the HA missed visits were communicated to the patient and/or their representative. i. Patient #137s election date was 03/16/24. HA services were ordered with frequencies of 1 visit every week for 9 weeks starting 03/18/24. The record showed the following missed visits: i. On 05/05/24, a missed visit note showed scheduling conflict. ii. On 07/03/24, a missed visit note showed scheduling conflict. iii. On 07/24/24, a missed visit note showed scheduling conflict. iv. On 08/28/24, a missed visit note showed scheduling conflict There was no other documentation to show the HA missed visits were communicated to the patient and/or their representative. j. Patient #138s election date was 04/30/24. HA services were ordered with frequencies of 2 visits every week for 7 weeks starting 05/15/24. The record showed the following missed visits: i. On 05/07/24, a missed visit note showed visit declined. ii. On 05/16/24, a missed visit note showed visit declined. iii. On 05/20/24, a missed visit note showed visit declined. iv. On 05/23/24, a missed visit note showed visit declined. v. On 05/27/24, a missed visit note showed visit declined. vi. On 07/22/24, a missed visit note showed visit discrepancy. There was no other documentation to show who declined the missed visits and that the HA missed visits were communicated to the patient and/or their representative. k. Patient #139s election date was 08/6/23. HA services were ordered with frequencies of 2 visits every week for 8 weeks starting 06/02/24. The record showed the following missed visits: i. On 07/05/24, a missed visit note showed visit declined. ii. On 07/30/24, a missed visit note showed visit declined. There was no other documentation to show who declined the missed visits and that the HA missed visits were communicated to the patient and/or their representative. l. Patient #140s election date was 06/17/24. HA services were ordered with frequencies of 1 visit every week for 12 weeks starting 06/18/24. The record showed the following missed visits: i. On 07/24/24, a missed visit note showed visit discrepancy. ii. On 07/30/24, a missed visit note showed visit declined. There was no other documentation to show who declined the missed visit and that the HA missed visits were communicated to the patient and/or their representative. m. Patient #141s election date was 03/07/24. HA services were ordered with frequencies of 1 visit every week for 13 weeks starting 06/25/24. On 07/24/24, a missed visit note showed scheduling conflict. There was no other documentation to show the HA missed visit was communicated to the patient and/or their representative. n. Patient #142s election date was 08/17/24. HA services were ordered with frequencies of 1 visit every week for 13 weeks starting 08/18/24. On 09/04/24, a missed visit note showed scheduling conflict, visit was not made. There was no other documentation to show the HA missed visit was communicated to the patient and/or their representative. 3. On 09/26/24 at 11:00 AM, Surveyor #1 interviewed the agencys Hospice Director (Staff #104) regarding the HA missed visit notes. Staff #104 acknowledged the findings and was unable to provide documentation to show that the patient and/or their representative were contacted regarding their missed visits.”