Every finding on record at Ak Care Hospice

Upon patient record review, 2 of 14 (Patients #3 and #11) 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 #3: Patient Medication Profile indicated Ibuprofen 600 mg. During reconciliation of meds on home visit, the patient had buprofen800 mg, not 600mg. Patient #11: The record reflected the patient had an oxygen concentrator. There was no oxygen listed on medication profile.

Upon patient record review, 2 of 14 (Patients #3 and #11) 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 #3: Patient POC/orders indicated Ibuprofen 600 mg. During reconciliation of meds on home visit, the patient had ibuprofen was 800 mg, not 600mg. Patient #11: The record reflected the patient had an oxygen concentrator. There was no oxygen listed on the POC.

Upon client record review, 5 of 14 (Patients #7, #9, #10, #11, #12) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #7: The POC listed Skilled Nursing visit frequency of, 2 X's per week (2/26/24). For 1st and 2nd Benefit Weeks there was only 1 visit on 2/26 and 3/4. Benefit Week 3 (3/10) there were no visits made. Benefit Weeks 4 through 7 (3/31, 4/7, 4/14 and 4/280, there were only one visit made on these weeks 3/20, 4/5, 4/13.4/19 and 4/27. Patient 9: The POC listed MSW visit frequency of, 1 X's per week (1/18/24). The MSW visited once monthly in February, March and April. The POC listed the SC visit frequency per week and every Benefit Period. The SC visited in January and April Benefit periods only. Patient #10: The POC had no visit frequency for the SN or SC. These disciplines have been visiting patient SN (weekly) and SC (monthly) since SOC (1/18/24) with no order. Patient #11: The POC had no visit frequency for the SN or SC. These disciplines had been visiting patient SN (weekly) and SC (monthly) since SOC (8/6/23) with no order. Patient #12: The POC had no visit frequency for the SN. The SN had been visiting patient SN (weekly) since SOC (11/14/23) with no order.

Upon patient record review, 7 of 14 (Patients #1, #2, #3, #4, #5, #7, #13) did not have evidence that the medical director or physician designee provides written certification that it is anticipated that the patient's life expectancy is 6 months or less if the illness runs its normal course. The physician must consider the following when making this determination: • Related diagnosis Patients #1, #2, #3, #4, #5, #7, #13: The CTI included hospice primary diagnosis only. The CTI did not include any related or unrelated diagnosis in space provided on form or in physician narrative. Educated agency on requirements.

Upon patient record review, 1 of 14 (Patient #3) did not have evidence that before the recertification period for each patient, the medical director or physician designee must review the patient's clinical information and provide written documentation that it is anticipated that the patient's life expectancy is 6 months or less. Patients #3: The CTI recertification included hospice primary diagnosis only. The CTI did not include any related or unrelated diagnosis in space provided on form or in physician narrative. Educated agency on requirements.

Upon patient record review, 1 of 14 (Patient #2 ) did not have evidence in the patient record that the interdisciplinary group, as part of the review of the plan of care, determines the ability of the patient and/or family to safely self-administer drugs and biologicals to the patient in his or her home. Patient #2: The assessment to identify patient/caregiver to safely administer meds in home was not completed and left blank in area designated for this assessment.