Every finding on record at Amedisys Hospice, LLC

Upon patient record review, 1 of 8 (Patient #5) 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 #5: The medication profile included acetaminophen suppository 650mg insert one every 6 hours PRN, butalbital-acetaminophen-caffeine 50/325/40 one tablet daily, and hydrocodone 5/325mg one tablet every 4 hours PRN however, there was no maximum allowable dose. COS

Upon patient record review, 3 of 8 (Patient #2, #3, #5) 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 #2: The patient admitted for Alzheimer's disease, however there was no evidence of problems/interventions/goals for neurological. COS Patient #3: The patient admitted on Eliquis however, there was no evidence of safety precautions for bleeding. COS Patient #5: The nursing notes since the beginning of June noted patient was having bouts of nausea and vomiting however, there was no evidence of problems/interventions/goals to address these concerns. COS

Upon patient record review, 1 of 8 (Patient #5) 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 #5: The orders included acetaminophen suppository 650mg insert one every 6 hours PRN, butalbital-acetaminophen-caffeine 50/325/40 one tablet daily, and hydrocodone 5/325mg one tablet every 4 hours PRN however, there was no maximum allowable dose. COS

Upon patient record review, 4 of 8 (Patient #2, #3, #5, #6) 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 equipment and supply needs. Patient #2: The medication profile listed patient using albuterol medication however, there was no evidence on the plan of care for a nebulizer machine. COS Patient #3: The nurse noted upon admission patient has a bedside commode however, there was no evidence of this on the plan of care. COS Patient #5: Upon visit in home patient stated he uses cane to ambulate however, there was no evidence this was on the plan of care. COS Patient #6: The medication profile listed oxygen, and several notes from May forward noted patient was using wheelchair/transport chair however, there was no evidence of these equipment items listed on the plan of care.

Upon client record review, 3 of 8 (Patient #1, #3, #6) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #1: The nurse visit frequency ordered 05/30/2023 was 5W1, 2W12 however, the week of 05/28 there was only evidence of two visits on 05/30 and 06/02. COS Patient #3: The social work visit frequency ordered 05/20/2023 was 4M1, 2M2, 1M1 however, there was only evidence of one visit on 05/24 and 06/09. COS Patient #6: The nurse visit frequency ordered 05/14/2023 was 9W1, 3W11 however, the week of 05/14 there was only evidence of visits 05/15, 05/17, and 05/19.

Upon observation, there was no evidence the hospice investigates all adverse events, incidents, accidents, variances or unusual occurrences that involve patient care and develops a plan of correction to prevent the same or similar event from occurring again. Patient #1: The nurse note on 06/27 listed the patient had a fall the day prior however, there was no evidence of this being investigated by the hospice. COS

Upon patient record review 1 of 8 (Patient #3) 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 #3: The aide visit frequency ordered 05/28/2023 was 2W11, 1W1 however, the weeks of 06/11 and 06/18 there was only one visit each week on 06/15 and 06/20. COS