Survey Report for 101545

DEPARTMENT OF HEALTH AND HUMAN SERVICES		FORM APPROVED
CENTERS FOR MEDICARE & MEDICAID SERVICES		OMB NO. 0938-0391
STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION	(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER	(X2) MULTIPLE CONSTRUCTION	(X3) DATE SURVEY COMPLETED
STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION	101545	A. BUILDING __________ B. WING ______________	11/06/2019
NAME OF PROVIDER OR SUPPLIER	STREET ADDRESS, CITY, STATE, ZIP
VITAS HEALTHCARE CORPORATION OF FLORIDA	4450 W EAU GALLIE BLVD STE 250, MELBOURNE, FL, 32934
For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See reverse for further instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation
LABORATORY DIRECTOR’S OR PROVIDER/SUPPLIER REPRESENTATIVE’S SIGNATURE		TITLE	(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
(X4) ID PREFIX TAG	SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY SHOULD BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION)
L0505
L0505	35086 Based on record review and interview, the Agency failed to initiate a grievance investigation for 1 of 4 sampled patients reviewed for grievances (#1). Findings: Patient #1 was admitted to Vitas hospice on 10/26/18 with terminal diagnosis of heart failure. He was a home patient under hospice care with his spouse as the primary caregiver. Patient #1's spouse could no longer provide the care at home and he was transferred to an assisted living facility (ALF) and had a change in the primary nurse to registered nurse (RN) E. On 11/06/19 at 11:17 AM, RN E verified that she had been caring for patient #1 at the ALF for the past several months, and she did not know why he was transferred to a different hospice. RN E said she just heard that he was going to different hospice. The medical record for patient #1 revealed that Team Manager (TM) B had documented on 9/25/19, late entry note for date of 9/23/19, read, "Received call from spouse...felt that [RN E] was a little too aggressive...Today I called and spoke with spouse after receiving a request to transfer from Vitas to another hospice...she needed to change because she felt [RN E] was too aggressive and not respectful to her husband and that her nursing skills were lacking...." On 11/05/19 at approximately 2 PM, Patient Care Administrator (PCA) D verified that the nurse's note written on 9/25/19 for patient #1 was written by TM B. However due to their system, he was not able to print the document showing the author as TM B. He confirmed that patient #1 was still under Vitas hospice care on 9/23/19 and had not yet transferred to new the hospice until 9/26/19. On 11/05/19 at 1:06 PM, TM B and PCA A verified that patient #1 had been under their care for almost a year starting out as a home patient and then transferring to the ALF. They were asked why a long-standing patient wanted to transfer. and TM B said the wife thought the assigned nurse was aggressive and did not think she was educated or doing the dressing changes properly to his lower extremities. The TM verified that she did not initiate their "Service Comment", which is a process that they use to address grievances, and had not talked with RN B regarding the spouse's concerns. PCA A, present during the interview, verified that since patient #1 had been long time patient for almost a year and the spouse expressed the concerns to the TM and wanted to switch to a different hospice, a "Service Comment" should have been initiated and they did not follow their process. On 11/05/19 at 3:49 PM, General Manager (GM) E confirmed that patient #1 should have had a "Service Comment" initiated by the TM on 9/23/19. Review of the agency management standard for "Service Comment Process", last revised 3/14/19 read, "What: A mechanism for identifying, recording, investigation, reviewing, resolving and trending service comments and grievances. Who: Vitas staff who receive a complaint or grievance. Considerations: All complaints and grievances received from patient, patient's family....or patient's health care provider regarding treatment, care, or respect for the active, discharged, pending....will be recorded via the Service Comment...The complaint/grievance investigation begins immediately by the Vitas employee who witnesses/receives the service issue...."