PRINTED: 07/08/2016 FORM APPROVED OMB NO. 0938-0391 (X3) DATE SURVEY COMPLETED 02/25/2014 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE MEDICAID SERVICES STATEMENT OF DEFICIENCIES (X1) AND PLAN OF CORRECTION IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION A BUILDING 021500 B. WING STREET ADDRESS, CITY, STATE. ZIP CODE 960 EAST BOGARD ROAD. SUITE 132 WASILLA. AK 99654 NAME OF PROVIDER OR SUPPLIER MAT-8U REGIONAL HOSPICE (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PLAN OF CORRECTION PREFIX TAG (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X5) COMPLETION DATE 000 INITIAL COMMENTS 000 The following de?ciencies were noted during an unannounced Medicare/Medicaid complaint investigation AK #2514 conducted 2/24-25/14. Sample size 4. STATE OF ALASKA Department of Health and Social Services Division of Health Care Services 4501 Business park Blvd. Ste. 24, Anchorage, Alaska 99503 530 CONTENT OF COMPREHENSIVE 530 ASSESSMENT [The comprehensive assessment must take into consideration the following factors:] (6) Drug pro?le. A review of all of the patient's prescription and over-the-counter drugs, herbal remedies and other alternative treatments that could affect drug therapy. This includes, but is not limited to, identi?cation of the following: Effectiveness of drug therapy (ii) Drug side effects Actual or potential drug interactions (iv) Duplicate drug therapy Drug therapy currently associated with laboratory monitoring. LABORATORY OR REPRESENTATIVES SIGNATURE TITLE (X6) DATE Any de?ciency statement ending with an asterisk denotes a de?ciency which the institution may be excused from correcting providing it is detennined that other safeguards provide suf?cient protection to the patients. (See instructions.) Except for nursing homes, the ?ndings 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 ?ndings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If de?ciencies are cited, an approved plan of correction is requisite to continued program participation. FORM Previous Versions Obsolete Event Facility ID: 021500 If continuation sheet Page 1 of 11 PRINTED: 07/08/2016 DEPARTMENT OF HEALTH AND HUMAN SERVICES FORM APPROVED CENTERS FOR MEDICARE MEDICAID SERVICES OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (x1) (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING COMPLETED 021500 3- 0212512014 NAME OF OR SUPPLIER STREET ADDRESS, CITY, STATE. ZIP CODE MAT-8U REGIONAL HOSPICE 960 EAST BOGARD ROAD, SUITE 132 WASILLA, AK 99654 (x4) ID SUMMARY STATEMENT OF DEFICIENCIES ID PROVIDERS PLAN OF CORRECTION (x5) PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE TAG REGULATORY OR LSC IDENTIFYING INFORMATION) TAG CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY) 530 Continued From page 1 530 This STANDARD is not met as evidenced by: Based on medical record review. policy review and interview the hospice agency failed to ensure new medication orders were reconciled with initial and/or on-going medication list in 4 of 4 patients 1; 2; 3; and 4) for whom medications were reviewed. As a result these patients were placed at risk for adverse events related to medication interactions. lack of medications. or, inappropriate dosage of medications. Findings: All medical records and policy and procedure reviews were completed between 2/24-25/14. Patient #1 Patient #1 was admitted to the hospice agency with a primary diagnosis of metastatic prostate cancer. Record review of Patient #1?s 485 (Initial Plan of Treatment and Certi?cation) for the certi?cation period Of 12/27/13 to 3/26/14 revealed Patient #1 was to receive the following medications: Colace 100 mg daily (reason-constipation); Fentanyl Transderrnal patch 75 mcg.hr, 1 every 72 hours(reason- pain); Miralax, 17 gram, 1. daily (reason-constipation); Oxycodone 30 mg 1, every 4 hours/pm [as needed] (reason-pain); Percocet 10-325 mg, 1 every 4 hours/pm (reason-pain); Senna, 176 mg/5 ml, 1 daily (reason-constipation). FORM Previous Versions Obsolete Event Facility ID: 021500 If continuation sheet Page 2 Of 11 DEPARTMENT OF HEALTH AND HUMAN SERVICES PRINTED: 07/08/2016 FORM APPROVED CENTERS FOR MEDICARE VIEDICAID SERVICES OMB NO. 0938-0391 STATEMENT oF DEFICIENCIES (x1) (x2) MULTIPLE CONSTRUCTION (x3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A BUWNG COMPLETED 021500 3- WING 0212512014 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS. CITY. STATE. ZIP CODE MAT-8U REGIONAL HOSPICE 960 EAST ROAD, SUITE 132 WASILLA, AK 99654 (x4) .0 SUMMARY STATEMENT OF DEFICIENCIES ID PROVIDERS PLAN OF CORRECTION (x5) paEle (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE common TAG REGULATORY OR IDENTIFYING INFORMATION) TAG CROSS-REFERENCED To THE APPROPRIATE DATE DEFICIENCY) 530 Continued From page 2 530 Review of the physician orders, dated 12/17/13, revealed the physician had prescribed Morphine Sulfate (MS) 20mg/ml at 0.5-1 ml by mouth every hour as needed for pain and shortness of breath. The physician's order also included Lorazepan 2 at 0.5 ml by mouth every hour as needed for agitation. These orders were sent to the hospice agency on 12127113; however, these medications were not included in the initial Mediation Pro?le or any other mediation list thereafter. Medial review of a Client Coordination Note Report, dated 111114, con?rmed the Patient's spouse was giving liquid morphine to the Patient Additional medial record review of a Client Coordination Note Report, dated 112/14, revealed the Patient's spouse had increased the Patient's Fentanyl patch from 75-100 meg/hour. The increase in the dose of the pain patch was not reconciled in the Patient?s Mediation Pro?le. Review of physician orders on 2124-25114 for Patient #3 2; 3; and 4 revealed there were also changes in these patients' mediations that had not been reconciled on the medial record Mediation Pro?les. Review of the agency's "Medications", dated FORM Previous Versions Obsolete Event ID: 969N11 Facility ID: 021500 If continuation sheet Page 3 of 11 PRINTED: 07/08/2016 DEPARTMENT OF HEALTH AND HUMAN SERVICES FORM APPROVED CENTERS FOR MEDICARE MEDICAID SERVICES OMB N0. 0938-0391 STATEMENT OF DEFICIENCJES (X1) (X2) MTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION A BLILDING COMPLETED 021500 a 0212512014 NAME OF PROVIDER OR STREET ADDRESS. CITY. STATE. ZIP CODE musraomnomsunern MAT 6U REGIONAL HOSHCE WASILLA. AK 99354 (x0 .0 WY STATEMENT OF DEFICIENCIES To PROVIDERS PLAN OF CORRECTION as) (EACH DEFICIENCY MOST as av Fuu. PREFIX (EACH CORRECTIVE ACTION SHOULD BE cm TAG OR LSC mm MOMATIONI TAO CROSS-REFERENCE TO APPROPRIATE WE DEFICIENCY) 530 Continued From page 3 530 7/10, revealed "Agency will implement a standardized method for creating an accurate list of medications at admission/entry. on-going and transfer/discharge. The comprehensive assessment includes a review Of all current oventhe-counter (OTC) medications, oxygen. vitamins. prescribed ointments. herbal/dietary supplements and nutrition supplements will be listed on the Mediation Pro?le.? During an interview on 2125/14 at 330 am the Director Of Nurses (DON) con?rmed patient It's 1; 2:3; and4hadmediationchangesthathad been ordered by their physicians electronially, and that the nursing staff had not included these - changes in the medial record Mediation Pro?le. The DON said the problem was the agency?s computer system used for physician orders was notthesamesystern usedforpatients'data collection in the agency?s patient electronic medial record. Therefore. beause two different computer systems were in use, nurses would forget to include the mediation changes in the patients' medial record. The surveyor asked would Mediation Pro?les not being updated place patients at a higher risk for not receian mediations? The DON con?mIed it did place patients at a higher risk for mediation errors. 539 APPROACH TO SERVICE 539 DELIVERY (1) The hospice must designate an interdisciplinary group or groups composed of FORM Provrous vesions Obsolete Event Fad?y 0' 021500 Ifoon?nua?on sheet Page 4 of 11 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE VIEDICAID SERVICES PRINTED: 07/08/2016 FORM APPROVED OMB NO. 0938-0391 individuals who work together to meet the physical, medical, emotional. and spiritual needs of the hospice patients and families facing terminal illness and bereavement. Interdisciplinary group members must provide the care and services offered by the hospice, and the group, in its entirety. must supervise the care and services. This STANDARD is not met as evidenced by: Based on record review, policy review and interview the hospice agency failed to ensure care and service needs were adequately coordinated for 1 patient Of 4 patients for whom care and services were reviewed. The failed practice placed the patient and family at risk of not receiving the support required to meet their end of life needs: Findings: All medical records and policy and procedure reviews were completed between 2/24-25/14. Patient #1 Patient #1 was admitted to the hospice agency with a primary diagnosis Of metastatic prostate cancer. Record review Of Patient #1's 485 (Initial Plan of Treatment and Certi?cation) for the certi?cation period of 12/27/13 to 3/26/14 revealed Patient #1 was to receive the following medications: Colace 100 mg daily (reason-constipation); Fentanyl Transdermal patch 75 mcg.hr, 1 every 72 hours(reason- pain); Miralax, 17 gram. 1, daily (reason-constipation); Oxycodone 30 mg 1, every STATEMENT OF DEFICIENCIES (x1) (X2) MULTIPLE CONSTRUCTION Ixai DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A BUILDING 021500 3- 02/25/2014 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY. STATE. ZIP CODE T-su REGIONAL HOSPICE 950 EAST BOGARD ROAD, SUITE 132 MA WASILLA. AK 99654 (x4) .0 SUMMARY STATEMENT OF DEFICIENCIES Io PLAN OF CORRECTION (st (EACH DEFICIENCY MUST BE PRECEDED BY FULL (EACH CORRECTIVE ACTION SHOULD BE TAG REGULATORY OR LSC IDENTIFYING INFORMATION) TAG CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY) 539 Continued From page 4 539 FORM Previous Versions Obsolete Event ID: 969N11 Facility ID: 021500 If continuation sheet Page 5 of 11 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE MEDICAID SERVICES PRINTED: 07/08/2016 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) AND PLAN OF CORRECTION IDENTIFICATION NUMBER: 021500 (X2) MULTIPLE CONSTRUCTION A BUILDING B. WING (X3) DATE SURVEY COMPLETED 02125I201 4 NAME OF PROVIDER OR SUPPLIER MAT-8U REGIONAL HOSPICE STREET ADDRESS. CITY. STATE. ZIP CODE 960 EAST BOGARD ROAD, SUITE 132 WASILLA, AK 99654 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PREFIX TAG PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X5) COMPLETION DATE 539 Continued From page 5 4 hours/prn [as needed] (reason-pain); Percocet 10-325 mg, 1 every 4 hours/pm (reason-pain); Senna, 176 mg/5 ml, 1 daily (reason-constipation). Additional review of the 485 revealed the Patient was to receive the following services: SN 1time a week for1week, 2 times a week for 2 weeks. 1 time a week for 13 weeks. with 3 pm visits for Shortness of Breath (SOB), pain or anxiety. Effective 12/29/13, MSW (medical social worker) at1 time a week for 1 week; hospice volunteer pm; and chaplain to evaluate. Review of the documented nursing visits for the ?rst week of service (12/27/13-1/3/14) revealed nursing staff had made a home visit on the 12/27/13 for the admit assessment; a nursing home visit was made on 12/31/13 because the patient's spouse wlled upset because the Patient was experiencing more pain. The next nurse home visit was on 1/2/14 late in the afternoon after the Patient's spouse called because she did not think the medication she was giving was addressing the Patient's pain. She requested more guidance on how to administer the Patient's pain medications. The spouse expressed she was frustrated and angry that she was unable to get the liquid Methadone. The last nurse home visit was on 1/4/14 at the time of the Patient's death. Review of the Client Coordination Note Reports 539 FORM Previous Versions Obsolete Event ID: 969N11 Facility ID: 021500 If oontinuation sheet Page 6 of 11 PRINTED: 07/08/2016 DEPARTMENT OF HEALTH AND HUMAN SERVICES FORM APPROVED CENTERS FOR MEDICARE VIEDICAID SERVICES OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (x1) (x2) MULTIPLE CONSTRUCTION (x3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A BUILDING COMPLETED 021500 e. WING 0212512014 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY. STATE, ZIP CODE MAT 3U REGIONAL HOSPICE 950 EAST BOGARD ROAD. SUITE 132 WASILLA, AK 99654 (x4) .0 SUMMARY STATEMENT OF DEFICIENCIES Io PROVIDERS PLAN OF CORRECTION m, pREf-?lx (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE TAG REGULATORY OR LSC IDENTIFYING INFORMATION) TAG CROSS-REFERENCED To THE APPROPRIATE DATE DEFICIENCY) 539 Continued From page 6 539 Review of a Client Coordination Note Report, dated 1/1/14. revealed the Patient?s spouse called "stating that Patient has now become semi-conscious and unable to swallow. She is needing guidance on use of medication. We discussed use of the liquid morphine and as long as this controls his pain we Should be just ?ne. She verbalized understanding. She remembers that she could crush the oxycodone if She needed to as well." Review of a Client Coordination Note Report. dated 1/2/14. revealed the patient's spouse had called the hospice agency that morning and was not able to get her questions answered for Obtaining liquid Methadone instead of crushing the pill form Of Methadone to address the Patient?s uncontrolled pain.The spouse was not able to talk with a nurse at the time of the call. A second note Client Coordination Note Report, dated 1/2/14, revealed at 9:50 am an on-call hospice nurse called the patient's spouse back. "Called [name omitted] after she called of?ce to ask about medications. She is expressing frustration and says she in very upset that she has not received any liquid Methadone yet and no one had called her 1st thing this morning. She says she has given husband crushed Methadone at 1615 yesterday and again early this am. She has given 2 doses of the Oxycodone, crushed. She has the liquid Morphine she has not used. FORM Previous Versions Obsolete Event ID: 969N11 Facility ID: 021500 If continuation sheet Page 7 0f 11 DEPARTMENT OF HEALTH AND HUMAN SERVICES PRINTED: . 07/08/2016 FORM APPROVED CENTERS FOR MEDICARE VIEDICAID SERVICES OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (x1) (x2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A. BUILDING COMPLETED 021500 3- WING 02125/2014 NAME OF PROVIDER OR SUPPLIER MAT-5U REGIONAL HOSPICE STREET ADDRESS, CITY, STATE, ZIP CODE 960 EAST BOGARD ROAD, SUITE 132 WASILLA, AK 99654 SUMMARY STATEMENT OF DEFICIENCIES He does have a 100 Fentanyl patch on. Her understanding was that a liquid Methadone script was to be delivered today. She had called Geneva Woods and they told her they do not have a script and do not have the medications. [Name omitted] has put a call into Dr. [name omitted] at 0900. I told her I will call Dr. [name omitted] back now. She says it won't do any good, he won't all you back. I reviewed giving the crushed Methadone tablets and asked how many she has. She said she's not sure, it doesn't matter, because he's not absorbing it all when I only give it crushed. She says he is semiconscious and only moans or to talk when he needs to urinate. He might be in pain then, but she is not sure. I offered to come out, she declined. I offered to send [name omitted] MSW out, she responded with I'll just call her myself and hung up on me. [Name omitted], RN noti?ed 1020: Called [name omitted] back with [name omitted], Administrator. She again expressed her frustration with [name omitted]. Again says that he is not getting the Methadone into his body by crushing it. I attempted to let her know that Geneva Woods does not have any liquid Methadone and per [name omitted]'s communication 90 Methadone [pills] only. She says she called them and they do have liquid Methadone and the point is we can't get Dr. [name omitted]. I told her we will keep trying to call him." Review of a nursing visit note, dated 1/2/14, at 5:21 pm, revealed "[Name omitted], wife, very tearful. Son at side, discussed use of Ativan for [Patients] obvious anxiety. [Name omitted] verbalized understanding and say she will use tonight. She is very tired and Son says she does not rest even with his being there." (x4) .0 ID PLAN OF CORRECTION (x5) (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETION TAG REGULATORY OR LSC IDENTIFYING INFORMATION) TAG TO THE APPROPRIATE DATE DEFICIENCY) 539 Continued From page 7 539 FORM Previous Versions Obsolete Event ID: 969N11 Facility ID: 021500 If continuation sheet Page 8 of 11 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE MEDICAID SERVICES PRINTED: 07/08/2016 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) AND PLAN OF CORRECTION IDENTIFICATION NUMBER: 021500 (X2) MULTIPLE CONSTRUCTION A. BUILDING B. WING (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OR SUPPLIER MAT-SU REGIONAL HOSPICE STREET ADDRESS. CITY. STATE. ZIP CODE 950 EAST BOGARD ROAD, SUITE 132 WASILLA, AK 99654 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PLAN OF CORRECTION (X5) PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETION TAG CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY) 539 Continued From page 8 During an interview on 2/25/14 at 9:30 am and then again at 10:30 am with the Director of Nurses (DON), the surveyor questioned if there were issues with the coordination of care for this Patient and family. The DON said the Patient was admitted during a busy time of the year and that there were 3 nurses (1 on-call nurse and 2 hospice nurses) involved with evaluating and providing guidance to the Patient's wife concerning the Patient's anxiety and pain control. The DON said the regular hospice physician was on vacation during the time the Patient's spouse was trying to contact him. She said the hospice agency did have an on-call physician in place, but did not know if that was communicated to all of the staff and the Patient's family. During the time of the Spouse's concern pertaining to medications and pain control the primary hospice nurse had just come off from several days of vacation and had been called in on jury duty on 1/2/14 so she was not available to meet with the family until late in the evening on 1/2/14. The second hospice nurse was leaving on vacation on 1/1/14 and no other nursing staff went out to see the family during the day shift of 1/2/14. The DON said that looking back at the situation and how the Patient's spouse was handling the end of life care of the Patient, a nurse should have made a home visit between 12/27/14 - 12/31/13 instead of just calling the Patient's spouse. She also said on the morning of 1/2/14 the on-call nurse who had responded back to the Patient's spouse was not use to working with the 539 FORM Previous Versions Obsolete Event ID: 969N11 Facility ID: 021500 If continuation sheet Page 9 of 11 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE VIEDICAID SERVICES 07/06/2016 FORM APPROVED OMB NO. 0938-0391 family and may not have been as aware of the Patient and family needs as the primary hospice nurse. In addition, the Inter?disciplinary Group (IDG) had not yet met to discuss coordination of service needs, which in a normal scenario would have happened during the IDG meeting. The DON said the Patients spouse was given incorrect information concerning the liquid Methadone order that was supposed to have been at the local pharmacists. The DON said it may have been because the Patient's wife was referencing it as an order from the primary hospice physician when the order was obtained from the on-call physician. The DON also said the Patient's wife was very frustrated and angry because she had been calling the primary hospice physician and since he was on vacation he had not responded to her calls. When the surveyor asked if the accumulation of staff changes; medication changes and lack of medication changes being updated on the medication pro?le; physician on?call changes; pharmacy pick-Up verses delivery changes; phone calls from staff instead Of nurse home visits; could have contributed to a lack of coordination of care for the Patient and spouse? The DON con?rmed after reviewing the events she felt it had. Review of the agency's policy and procedure "Care Planning Process, Coordination and Continuity" dated 7/10, revealed "The hospice will maintain a system of communication and integration in accordance with the hospice's own policies and procedures to: 1. Ensure the interdisciplinary group, through its designated STATEMENT OF DEFICIENCIES (x1) (x2) MULTIPLE CONSTRUCTION (x3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. BUILDING 021500 3' 0212512014 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS. CITY. STATE, ZIP CODE MAT-8U REGIONAL HOSPICE 950 EAST BOGARD ROAD, SUITE 132 WASILLA, AK 99654 (x4) ID SUMMARY STATEMENT OF DEFICIENCIES ID PROVIDERS PLAN OF CORRECTION (st PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETION TAG REGULATORY OR LSC IDENTIFYING INFORMATION) TAG CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY) 539 Continued From page 9 539 FORM Previous Versions Obsolete Event ID: 969N11 Facility ID: 021500 If continuation sheet Page 10 of 11 DEPARTMENT OF HEALTH AND HUMAN SERVICES PRINTED: 07/08/2016 FORM APPROVED OMB NO. 0938-0391 CENTERS FOR MEDICARE MEDICAID SERVICES STATEMENT OF DEFICIENCIES (X1) (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A BUILDING COMPLETED 021500 3- 0212512014 NAME OF PROVIDER OR SUPPLIER MAT-8U REGIONAL HOSPICE STREET ADDRESS. CITY. STATE, ZIP CODE 950 EAST BOGARD ROAD, SUITE 132 WASILLA, AK 99654 professionals. maintains responsibility for directing, coordinating, and supervising the care and services provided; and 2. Provide for and ensure the ongoing sharing of information between all disciplines providing care and services in the home, outpatient settings. and in inpatient settings, irrespective whether the care or services are provided directly or under arrangement." (x4) ,0 SUMMARY STATEMENT OF DEFICIENCIES ID PLAN OF CORRECTION (st pamx (EACH DEFICIENCY MUST BE PRECEDED ev FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETION TAG REGULATORY 0R LSC TAG CROSS-REFERENCED TO THE APPROPRIATE DATE DEFICIENCY) 539 Continued From page 10 539 FORM Prevrous Versions Obsolete Event ID: 969N11 Facility ID: 021500 If continuation sheet Page 11 of 11