Every finding on record at Better Life Hospice

Upon patient record review, 1 of 16 (Patient #7) 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 #7-11/4/24 Orders for Diclofenac Gel, no evidence of specific location identified in the medication profile.

Upon patient record review, 1 of 16 (Patient #10) did not have evidence in the patient record that the comprehensive assessment includes a bereavement component which includes the needs of the patient's family and other individuals focusing on the social, spiritual, and cultural factors that may impact their ability to cope with the patient's death. Information gathered from the initial bereavement assessment is incorporated into the plan of care and is considered in the bereavement plan of care. Patient #10-No evidence of initial bereavement assessment completed.

Upon patient record review, 1 of 16 (Patient #7) 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 #7-11/4/24 Orders for Diclofenac Gel, no evidence of specific location identified in the plan of care.

Upon client record review, 1 of 16 (Patient #1) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #1-LVN visits ordered 1x/week, no evidence of LVN visit the week of 6/27/25.

Upon patient record review 2 of 16 (Patient #1,8) 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 #1-8/1/25 No evidence of Aide completing the tasks of Patient Status, Mental Status and Precautions as ordered on the Aide Care Plan. Patient #8-4/29/25 No evidence of aide completing the tasks for Non-Ambulatory, Transfer, Dressing, Feeding, Oral Care, Oxygen and Housekeeping as ordered on the Aide Care Plan.

Upon patient record review 1 of 16 (Patient #8) did not have evidence documentation in the patient record that a Registered Nurse made an on-site visit to the patient's home no less frequently than every 14 days to assess the quality of care and services provided by the hospice aide and to ensure that services ordered by the hospice interdisciplinary group meet the patient's needs. Patient #8-Aide visit frequency is 2x/week, no evidence of supervisory visit made the weeks of 3/4/25, 3/10/25, 4/7/25, 4/21/25, 5/5/25 and 5/19/25.

Upon patient client record review, 2 of 16 (Patient #1,8) did not have evidence that each patient record contains: • Signed copies of the notice of patient rights in accordance with 418.52 • Signed election statement in accordance with 418.24 Patient #1 & Patient #8-Consents "Effective Date" is blank, Corrected on site.

Upon client record review, 1 of 16 (Patient #7) did not have evidence that if a patient revokes the election of hospice care or is discharged from hospice in accordance with §418.26, the hospice must forward to the patient's attending physician: • A copy of the hospice discharge summary • The patient's clinical record, if requested Patient #7-No evidence of a discharge summary was completed or sent to the attending physician upon revocation.

Upon patient record review, 1 of 5 (Patient #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 #5- The patient was on Eliquis, the plan of care did not include goals and interventions related to bleeding risk.