Every finding on record at Advent Hospice Care Inc

Upon patient record review, 1 of 14 (Patient #7) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient 7: At the time of the initial assessment on 5/14/25, the RN indicated MD orders obtained for supplemental oxygen therapy as needed for dyspnea with moderate exertion. There was no documented evidence found of problems, interventions, or goals related to teaching of the safe and appropriate use of Oxygen and the controlling or managing of symptoms.

Upon client record review, 1 of 14 (Patient #9) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient 9: The plan of care recorded LVN visits at a frequency of 1 time weekly. There was no evidence of an LVN visit the week of 7/13/25 and the week of 7/27/25.

Upon patient record review 1 of 14 (Patient #4) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient 4: Hospice aide documentation recorded a bed bath was given at the visit on 8/06/25 despite "shower every visit" being indicated on the aide instructions.

Upon client record review, 2 of 14 (Patient #11, 12) did not have evidence that if a patient revokes the election of hospice care or is discharged from hospice in accordance with §418.26, the hospice must forward to the patient's attending physician: • A copy of the hospice discharge summary • The patient's clinical record, if requested Patient 11 and 12: There was no documented evidence found in the medical record of the discharge summary being provided to the attending physician at the time or revocation.

Upon patient record review, 1 of 5 (Patient #2) did not have evidence in the patient record that a review was completed of all prescription and non-prescription medications, including herbal remedies that could affect drug therapy. This review includes, but is not limited to: • Effectiveness of drug therapy • Drug side effects • Actual or potential drug interactions • Duplicate drug therapy • Drug therapy currently associated with laboratory monitoring Patient #2 The medication profile includes an order for Diclofenac gel 1% apply 4 times a day. The medication profile does not include the application site for the medication.

Upon patient record review, 1 of 5 (Patient #2) did not have evidence the plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions, including medications and treatments. Patient #2 The medication order for Diclofenac 1% gel reads "apply 4 times a day." The order does not include the application site for the medication.