Every finding on record at Brother's Hospice and Palliative Care, Inc.

Upon patient record review, 1 of 5 (Patient #3) 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 Patient 3: Medication list entry indicates Tylenol 500mg 1tab po once daily every 6 hours PRN pain. The physician treatment order is written for every 6 hours PRN dosing only; the once daily dosing was entered on the medication list in error. (corrected onsite)

Upon patient record review, 1 of 5 (Patient #2) 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 2: The patient's primary terminal diagnosis is Alzheimer's disease. The physician's certification of terminal illness indicates a FAST score of 7A and that the patient is confused, withdrawn, and is unable to follow simple directions; it also notes the patient is fully dependent for ADLs. The SN's comprehensive initial assessment indicates the patient is confused, anxious, restless, and forgetful. Subsequent SN visit notes indicate inability to communicate verbally and reliance on family for all ADLs. During the home visit, the patient was observed to be nonverbal, anxious, and unable to follow commands. However, no care plan has been developed since the patient's hospice admission on 07.21.2022 related to the patient's neurological status or cognitive function. (corrected onsite)

Upon patient record review and during patient home visit, 1 of 5 (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 equipment and supply needs. Patient 1: The patient's plan of care indicates only the use of a cane for management of the terminal illness. During the home visit, the patient was observed to be utilizing a rollator walker. All equipment used by the patient must be included on the plan of care. (corrected onsite)