Healthcare Inspection Review of Hospice Care Issues VA Maryland Health Care System Baltimore, Maryland

The purpose of this review was to determine the validity of allegations that: the complainant’s husband (the patient) did not receive adequate pain medication, the clinicians did not provide the patient hospice care, and the patient’s physician did not communicate effectively with family members. We found that the patient’s physician did prescribe pain medications for the patient; however, the medical record documentation did not reflect pain assessments after each dose of pain medication. We found that a majority of the staff who cared for the patient was not trained in end of life issues and the interim plan of care did not include hospice care. The physician documented patient and family education regarding hospice care; however, we concluded that the family believed the physician did not provide adequate information regarding the patient’s plan of care. We recommended that: Pain assessments are documented in patients’ medical records according to the system’s policy. BRECC staff caring for hospice patients receive the required training. Patients admitted for hospice care are provided that care by a dedicated trained interdisciplinary hospice team.