Every finding on record at Blooming Rose Hospice, Inc.

Upon patient record review, 1 of 14 (Patient #1) 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 #1 Polyethylene Glycol powder 17 gram order with no diluent ordered on 6/7/24, Med profile did not have complete order. Corrected on Site

Upon patient record review, 1 of 14 (Patient #11) 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 #11: Patient Start of Care was 12/29/23. The initial Bereavement Risk Assessment was completed late (6/9/24).

Upon patient record review, 1 of 14 (Patient #7) 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. Patent #7: The Plan of Care indicated a "PRN visit added for fall" on 1/29/24. This order did not indicate discipline to visit.

Upon patient record review, 1 of 14 (Patient #1) 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 #1 Polyethylene Glycol powder 17 gram order with no diluent ordered on 6/7/24, Plan of Care did not have complete order. Corrected on Site

Upon patient record review, 1 of 14 (Patient #3) 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 #3: The record reflected that this patient had an APP Mattress. This patient had a regular mattress and no wound care issues. These items were not correctly identified on Plan of Care. Corrected on Site.

Upon patient record review, 1 of 14 (Patient #1) did not have evidence that a revised plan of care includes information from the patient's updated comprehensive assessment and must note the patient's progress towards outcome/goals from the plan of care. Patient #1: This patient started Continuous Care (CC) ordered on 4/21/24. The IDT updated Plan of Care for 5/2/24, 5/16/24 and 5/30/24 reflects that CC in place. However, per CC order this was discontinued on 4/24/24.