Every finding on record at Bayada Home Health Care. Inc.

It is required that the hospice Interdisciplinary Group, in consultation with the individual's attending physician (if any), completes an initial comprehensive assessment no later than five (5) calendar days after the election of hospice care, in accordance with CMS §418.24–the elements of the hospice care election statement. This standard was not met as evidenced by clinical record review and interview. In 1 of 19 (5%) clinical records reviewed, the hospice did not ensure that the initial comprehensive assessment was completed no later than five (5) calendar days after the election of hospice care. Clinical Record 2: The patient elected hospice care on 08/17/2023. The Social Work (SW) assessment was completed on 08/23/2023, six (6) days after the election of hospice care. A review of the clinical record revealed no documentation supporting the delay in the assessment's completion. During a joint clinical record review on 02/21/2024, the Clinical Manager agreed that the SW assessment was not done within the required (5) five days, and they could not find any documentation supporting the delay.

It is required that the documented comprehensive assessment includes a drug profile that contains the patient's current: prescription and over-the-counter (OTC) drugs; supplements; herbal remedies; [and] other alternative treatments that could affect drug therapy. The medication review process includes the identification of the following: the effectiveness of drug therapy; drug side effects; actual or potential drug interactions; duplicate drug therapy; [and] drug therapy associated with laboratory monitoring. The assessment includes evidence that common side effects of medication in the hospice populations are anticipated, and, as appropriate, preventive measurements are implemented to manage the side effects. The drug profile is updated per the hospice policy and procedure, but, at minimum, at the time of each comprehensive assessment and/or when new medication is added or changes are made to existing medication. This standard was not met as evidenced by clinical record review, interview, and observation. In 1 of 19 (50%) clinical records reviewed and home visits observed, the hospice did not ensure that the comprehensive assessment included a review of the patient's current medications. Clinical Record 13/Home Visit 4: The patient elected hospice care on 02/02/2023. During the home visit on 02/21/2024, the patient's wife stated that she had Liquid Imodium, Guaifenesin, and Flonase, which she gave the patient regularly when she felt it was needed. The wife said that he has been taking these medications for over a year. These medications were not documented on the hospice medication profile dated 02/06/2024, and there was no evidence that Imodium, Guaifenesin, and Flonase were reviewed with the patient's medication regimen.

It is required that each patient’s individualized written plan of care: includes all services necessary for the palliation and management of the terminal illness, including the following: drugs and treatment necessary to meet the needs of the patient. This standard was not met as evidenced by clinical record review and interview. In 1 of 19 (5%) clinical records reviewed, the agency did not ensure that all current medications necessary to meet the needs of the patient were included in the patient’s individualized written plan of care Clinical Record 13/Home Visit 4: The patient elected hospice care on 02/02/2023 with Alzheimer's disease. During the home visit on 02/21/2024, the patient's wife stated that she had Liquid Imodium, Guaifenesin, and Flonase, which she gave the patient regularly when she felt it was needed. The wife said that he has been taking these medications for over a year. The Plan of Care dated 02/06/2024 did not document Imodium, Guaifenesin, and Flonase.