Every finding on record at Amedisys Hospice, LLC

Upon patient record review, 1 of 19 (Patient #10) 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 10:The medical record includes an order to discontinue oxygen on 3/3/23. Oxygen remains profiled on the medication list.

Upon patient record review, 1 of 19 (Patient #7) did not have evidence that a Registered Nurse is designated to ensure continuous assessment of the patient and family's needs and to coordinate activities with other members of the interdisciplinary group (IDG). The IDG must work together and is responsible for supervision of the care and service for each patient and family. Patient 7:The medical record includes documentation on admission that the patient has a stage II pressure ulcer to the coccyx. The wound care policy for the agency notes that measurements should be completed at least weekly. There is no evidence of wound care measurements from 1/22/24 until the wound was inactivated on 2/16/24.

Upon patient record review, 2 of 19 (Patient #6,#14) 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 6:The medical record contains documentation on admission of a history of seizures with a comorbidity of seizure disorder. There is no evidence of problems, goals and interventions on the plan of care for assessment and management of seizures. Patient 14:The medical record contains documentation on admission of dysphagia to include aspiration precautions and education provided to caregiver related to care, prevention and management. There is no evidence of problems, goals and interventions on the plan of care for dysphagia.

Upon patient record review, 2 of 19 (Patient #4,#5) did not have evidence that a revised plan of care includes information from the patient's updated comprehensive assessment and must note the patient's progress towards outcome/goals from the plan of care. Patient 4:The medical record contains documentation of patient symptoms of constipation requiring pharmacological interventions of Senna on 1/23/24 and Lactulose on 2/6/24. There is no evidence of an update to the plan of care with problems, goals and interventions for management of constipation. Patient 5:The medical record contains documentation of collaboration with the physician on 3/11/24 and subsequent order for treatment of a urinary tract infection using Cipro 500 mg po daily for 7 days. There is no evidence of an update to the plan of care with problems, goals and interventions for management of an active infection.

Upon patient record review, 4 of 19 (Patient #2,#3,#6,#7) did not have evidence in the patient record that hospice aide assignments and duties are: • Assigned to a specific patient by a registered nurse that is a member of the interdisciplinary group • Written patient care instructions for a hospice aide must be prepared by a Registered Nurse who is responsible for the supervision of a hospice aide as specified under paragraph (h) of 418.76 • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. The use of “PRN” or “per patient choice”, for any task, whether personal care or non-personal care tasks, are not acceptable Patient 2:The patient plan of care includes fall, bleeding and seizure precautions. There is no evidence on the aide plan of care for fall bleeding and seizure precautions. Patient 3:The patient plan of care includes aspiration and bleeding precautions. There is no evidence on the aide plan of care for aspiration and bleeding precautions. Patient 6:The patient plan of care includes seizure precautions. There is no evidence on the aide plan of care for seizure precautions. Patient 7:The patient plan of care includes fall and oxygen precautions. There is no evidence on the aide plan of care for fall and oxygen precautions.

Upon patient record review 1 of 19 (Patient #13) 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 13: The aide plan of care includes task of change linens weekly and an aide visit frequency of 2 visits per week. The aide documentation notes that the task was provided every visit from 2/21/24 to 3/7/24.