Hospice Plan of Care Deficiency

Plan of Care, L-Tag 543, is one of the top cited deficiencies in hospice. This means the hospice failed to ensure all hospice care and services provided to patients and families followed an individualized written plan of care established by the interdisciplinary group.  Collaboration with the attending physician (as applicable), patient or patient representative, and the primary caregiver is required according to the patient’s needs if any of these individuals desire to participate.  This deficiency is a failure to meet the regulations stated in the standard 418.56(b).  Interdisciplinary team meetings must be a time to examine compliance to the current plan of care as well as the revised or continued plan of care.  This is a time for self-examination.  Hospice aides should report patient desired changes to the  aide care plan.  And, each ordered discipline should examine stated interventions, goals, and frequencies to ensure they have been compliant.  Documentation must reflect participation or non-participation of the attending physician, patient, patient rep, and primary caregiver.  Attention to the details will keep you out of trouble.