Every finding on record at Calm Care Hospice Inc

Upon patient record review, 1 of 14 (Patient #6) 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 #6: Medication profile lists Miralax powder for solution 17g oral daily as needed for constipation. No diluent listed.

Upon patient record review, 1 of 14 (Patient #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 #6: POC lists Miralax powder for solution 17g oral daily as needed for constipation. No diluent listed.

Upon client record review, 3 of 14 (Patient #2, 4, 8) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #2: POC ordered SC at recert. SC visit made on 2/16. No evidence of an order for the visit. Patient #4: POC ordered MSW at every recert. No evidence of a visit by the MSW in February at time of recert. Patient #8: POC ordered LVN 1xwk. 2 visits per week noted the wks of 10/15, 10/22, 10/29, 11/5, 11/12, 11/19. No evidence of an order changing the frequency.

Upon patient record review 3 of 14 (Patient #8, 9, 10) 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 #8: POC ordered aide 3xwk. Only 2 visits noted the wk of 1/28 on 1/29 and 2/2. No evidence of an order to change the frequency or a missed visit. Patient #9: POC ordered aide 3xwk. Wk of 2/4 only 2 visits noted on 2/5 and 2/9. No evidence of an order to change the frequency or a missed visit. Patient #10: POC ordered aide 3xwk. Only 1 visit noted the week of 12/24. No evidence of an order to change the frequency or a missed visit.