Every finding on record at Arias Hospice Care

Upon patient record review, 3 of 14 (Patient 10, 11 & 12 ) 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 medication profile includes “Acetaminophen 650 mg rectal supp 1 supp every 4 hours as needed for temp >101.5 and Tylenol 325 mg tab 2 tabs by mouth every 6 hours as needed for pain” with no daily dosage limit. Patient 11 medication profile includes “Acetaminophen 500 mg cap 1 cap orally every 6 hours as needed for mild pain, Acetaminophen 650 mg rectal supp 1 supp every 4 hours as needed for temp >101.5 and Norco 5mg-325 mg tab 1 tab orally every 6 hours pain” with no daily dosage limit. Patient 12 medication profile includes “Acetaminophen 500 mg cap 2 caps orally every 6 hours as needed for mild pain, Acetaminophen 650 mg rectal supp 1 supp every 4 hours as needed for temp >101.5 and Norco 5mg-325 mg tab 1 tab orally every 8 hours as needed for pain” with no daily dosage limit.

Upon patient record review, 10 of 14 (Patient 1, 2, 3, 6, 7, 8, 9, 10, 12 & 14) did not have evidence the plan of care must includes all services necessary for the palliation and management of the terminal illness and related conditions, including the following: • A detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs • The IDG demonstrates a proactive approach in developing each patient's plan of care by planning ahead for anticipated patient changes and needs. Decisions should reflect the patient/family preferences rather than be solely a response to a crisis. Patients 1, 2, 3, 6, 8, 9, 10 & 14 with no evidence of a detailed scope and frequency of services necessary to meet the specific patient and family needs. Plan of care includes "MSW 1 time then prn" with no specific number of prn visits. Patients 1, 2, 3, 7, 8, 9 & 12 with no evidence of a detailed scope and frequency of services necessary to meet the specific patient and family needs. Plan of care includes "SC 1 time then prn" with no specific number of prn visits.

Upon patient record review, 3 of 14 (Patient 10,11,12) 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 10 POC includes “Acetaminophen 650 mg rectal supp 1 supp every 4 hours as needed for temp >101.5 and Tylenol 325 mg tab 2 tabs by mouth every 6 hours as needed for pain” with no daily dosage limit. Patient 11 POC includes “Acetaminophen 500 mg cap 1 cap orally every 6 hours as needed for mild pain, Acetaminophen 650 mg rectal supp 1 supp every 4 hours as needed for temp >101.5 and Norco 5mg-325 mg tab 1 tab orally every 6 hours pain” with no daily dosage limit. Patient 12 POC includes “Acetaminophen 500 mg cap 2 caps orally every 6 hours as needed for mild pain, Acetaminophen 650 mg rectal supp 1 supp every 4 hours as needed for temp >101.5 and Norco 5mg-325 mg tab 1 tab orally every 8 hours as needed for pain” with no daily dosage limit.

Upon patient record review 3 of 14 (Patient 2, 11 & 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 2 POC with CHHA 2 X week; week of 12/10/23-12/16/23 no evidence of visits completed. Patient 11 POC with CHHA 2 X week; week of 12/31/23-01/06/24 no evidence of visits completed. Patient 13 POC with CHHA 2 x week; week of 10/29/23-11/4/23 no evidence of visits completed.