Every finding on record at Competent Hospice Inc

Upon patient record review, 7 of 15 (Patient 1, 5, 6, 7, 8 & 14) 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 medication profile included "Artificial Tears 0.2%-0.2%-1% Ophthalmic Solution 1 drop opthalmic daily as needed, instill 1 drop to affected eye daily as needed" without identifying right or left eye, "Acetaminophen 650mg rectal supp every 6 hours as needed for pain/fever and Norco 5mg-325mg tab 1 tab orally every 6 hours as needed for pain" with no daily dosage limit. Patient 5 medication profile included "Fluocinonide 0.05% Topical Cream apply once daily to affected area" with no location identified. Patient 6 medication profile included "Tylenol 325 mg cap 2 caps orally every 6 hours as needed for pain and Acetaminophen 650mg rectal supp every 6 hours as needed for pain/fever" with no daily dosage limit. Patient 7 medication profile included "Tylenol ES 500 mg cap 1 cap orally every 6 hours as needed for pain and Acetaminophen 650mg rectal supp every 6 hours as needed for pain/fever" with no daily dosage limit. Patient 8 medication profile included "Hydrocortisone 1% topical cream once daily as needed, apply thinly to affected area" with no location identified, "Acetaminophen 650mg rectal supp every 6 hours as needed for pain/fever and Acetaminophen 650mg arthritis pain relief extended release cap 1 cap orally every 6 hours as needed for pain" with no daily dosage limit. Patient 14 medication profile included "Tylenol ES 500 mg cap 1 cap orally every 6 hours as needed for pain and Acetaminophen 650mg rectal supp every 6 hours as needed for pain/fever" with no daily dosage limit.

Upon patient record review, 7 of 15 (Patient 1, 5, 6, 7, 8 & 14) 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 plan of care included "Artificial Tears 0.2%-0.2%-1% Ophthalmic Solution 1 drop opthalmic daily as needed, instill 1 drop to affected eye daily as needed" without identifying right or left eye, "Acetaminophen 650mg rectal supp every 6 hours as needed for pain/fever and Norco 5mg-325mg tab 1 tab orally every 6 hours as needed for pain" with no daily dosage limit. Patient 5 plan of care included "Fluocinonide 0.05% Topical Cream apply once daily to affected area" with no location identified. Patient 6 plan of care included "Tylenol 325 mg cap 2 caps orally every 6 hours as needed for pain and Acetaminophen 650mg rectal supp every 6 hours as needed for pain/fever" with no daily dosage limit. Patient 7 plan of care included "Tylenol ES 500 mg cap 1 cap orally every 6 hours as needed for pain and Acetaminophen 650mg rectal supp every 6 hours as needed for pain/fever" with no daily dosage limit. Patient 8 plan of care included "Hydrocortisone 1% topical cream once daily as needed, apply thinly to affected area" with no location identified, "Acetaminophen 650mg rectal supp every 6 hours as needed for pain/fever and Acetaminophen 650mg arthritis pain relief extended release cap 1 cap orally every 6 hours as needed for pain" with no daily dosage limit. Patient 14 plan of care included "Tylenol ES 500 mg cap 1 cap orally every 6 hours as needed for pain and Acetaminophen 650mg rectal supp every 6 hours as needed for pain/fever" with no daily dosage limit.

Upon patient record review 2 of 15 (Patient 3 & 12) 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 3 CHHA ordered 2 X W; week of 3/31/24-4/6/24 no visits made. Patient 12 CHHA ordered 2 X W; Week of 3/19/23-3/25/23 only 1 visit made.