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
261627 A. BUILDING __________
B. WING ______________ 		06/09/2021
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP
ST LUKE'S HOSPICE SERVICES 101 ST LUKES CENTER DRIVE, CHESTERFIELD, MO, 63017
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)
L0544      
29559 Based on policy review, record review, and interviews, St Luke's hospice failed to ensure that a patient's care giver(s) received appropriate education. The hospice provider had 48 current patients. Findings included: Review of the policy, last revised 05/2021, titled "Patient Plan of Care" showed in part that "The St. Luke's Hospice interdisciplinary group (IDG) develops and implements an individualized plan of care which reflects the patient/family needs and goals and includes all interventions and education needed". Record/Patient #3: Review of the hospice plan of care showed that the patient was admitted to service on 09/04/2020 for a terminal diagnosis of chronic obstructive pulmonary disease (COPD). The plan of care instructed the hospice registered nurse (RN) to teach the family/caregivers regarding hospice services and philosophy, terminal disease process, and symptom management. Review of the communication notes showed on 04/29/2021 at 8:26 AM that one of the patient's primary caregivers called the hospice regarding suction equipment and "inquired about continuous care". Review of the nurse's visit notes, showed the hospice RN-A assessed the patient on 04/29/21 at 9:35 AM. The family/caregivers were concerned with the patient's terminal secretions and the suction equipment not functioning properly. The nurse documented that the patient's respirations were even and unlabored, pain score was "0" (on a scale where 0 is no pain). The patient was unable to expectorate secretions. The patient was unresponsive. The nurse documented that the caregiver was upset that the suction machine did not have proper tubing previously, and that emergency medical services (EMS) was called to suction secretions from the patient and assist with the suction equipment. EMS was present during the visit. The caregiver asked about continuous care, the nurse documented that "pts symptom management could be handled at home with medications administered by the family". The nurse failed to educate the family on the availability of continuous care, and the criteria for continuous care to be implemented by the hospice IDG team. The patient was comfortable, without distress at the end of the RN visit at 10:25 AM. It should be noted that the hospice provider contacted the caregivers at 1:10 PM, 2:17 PM, and 6:40 PM, and sent an RN 11:25 PM. The patient was assessed as comfortable, which would not meet the provider's continuous care criteria. During an interview with RN-A on 06/08/2021 at 10:30 AM, the hospice nurse stated the following: - When asked if the the hospice provider offered continuous care, he/she stated "no"; and - When asked if he/she had ever informed the caregivers of Patient #3 that continuous care was unavailable from the hospice, he/she stated I informed the family multiple times that continuous care is something that we do not offer". During an interview with the hospice administrator on 06/08/2021 at 10:42 AM, she stated that the hospice nurse incorrectly educated the family about the availability of continuous care. The hospice offers continuous care, and all levels of required hospice care.