Every finding on record at Aseracare Hospice-Tennessee, L.L.C.

Upon patient record review, 2 of 19 (Patient #5,#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 5:The medication profile includes an entry on 7/24/24 for Remedy antifungal to affected area and an entry for Levaquin on 7/27/24 times 10 days. There is no evidence that the entry for antifungal cream includes a location for administration and the Levaquin remains profiled on 8/20/24. Patient 11:The medication profile includes an entry for Zithromax 250 mg tab with dose noted as per instructions and instructions with take per package instructions. There is no evidence of a dosage or administration instructions for the Zithromax.

Upon patient record review, 1 of 19 (Patient #13) 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 13:The medical record includes SN documentation of oxygen 2 liters per minute via nasal cannula as needed for SOB. There is no evidence of problems, goals and interventions for the safety and management of oxygen. COS

Upon patient record review, 3 of 19 (Patient #2,#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 medications and treatments. Patient 2:The plan of care includes an order on 5/6/24 for wound care to right elbow skin tear. The order does not include who is to perform care. Patient 5:The medical record contains SN documentation that oxygen is being used on 8/6, 8/8, and 8/16 at 3 liters per minute and on 8/13 at 4 liters per minute. The plan of care includes an order on 7/18/24 for oxygen to be delivered at 2.5 liters per minute. Patient 6:The medical record includes SN documentation on 8/13/24 that the patient is reporting symptoms of a yeast infection due to antibiotic use and SN follow up with pharmacy to insure that Diflucan is ready for pick up. There is no evidence that the plan of care includes an order for Diflucan.

Upon client record review, 1 of 19 (Patient #12) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient 12: The medical record includes SN documentation on 8/16/24 of a wound to the Achilles tendon area measuring 2.5cmx2cmx0.5cm and that the SN applied "skin and betadine". There is no evidence that the plan of care includes wound care orders for the wound.