Every finding on record at Curo Health Services, LLC

Upon client record review, 1 of 19 (Patient #1) did not have evidence that the plan of care included IDG's documentation of the patient's or families level of understanding, involvement and agreement with the plan of care. Patient #1: On 12-20-23, 12-24-23, 12-27-23, 1-9-23, 1-14-23 and 1-22-23, the SN documented the patient was not taking, or the family was not giving Oxycodone due to the unwanted side effects of the medication. Oxycodone remains on the plan of care upon documentation review.

Upon patient record review, 5 of 19 (Patient #1,#2, #11, #13, #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: On 12-6-23 the SN documented the patient, "wears O2 mostly at night." O2 is not on the medication profile. Patient #2: On 10-29-23, the SN documented the patient used, "O2 10L via NC during the day and uses Bipap at night." The medication profile only listed Bipap as the route for O2 and not NC. Patient #11:On 1-18-24, the SN documented the patient was using "Oxycodone" "3xday" . There was no evidence the patient was using Oxycodone, but was using Hydrocodone. Patient #13: On 1-9-24, the SN documented the patient had "mild neck and back pain for which he takes Ibuprofen." Ibuprofen was not on the medication profile. Patient #14: On 11-26-23, the SN documented the family was, "not giving melatonin as ordered" and on 1-8-24, the SN documented, "Tylenol use is effective with pain management." Neither drug is on the medication profile.

Upon patient record review, 2 of 19 (Patient #13,#14) did not have evidence the plan of care includes all services necessary for the palliation and management of the terminal illness including medications and treatments. Patient #13: On 1-9-24, the SN documented the patient had "mild neck and back pain for which he takes Ibuprofen." however, there was no evidence of an order. Patient #14: On 11-26-23, the SN documented the family was, "not giving melatonin as ordered" and on 1-8-24, the SN documented, "Tylenol use is effective with pain management." There was no evidence of an order for either medication.

Upon patient record review, 2 of 19 (Patient #1,#7) 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: 12-17-23, the SN documented the patient had a "boil on the R buttock" and notified the MD, and on 1-8-24, the SN documented the wound was healed. There was no plan of care or interventions for integumentary issues. Patient #7: On 12-23-23, the SN documented the patient had a "skin tear" and the "son applied steri-strips." On 1-15-24, the SN documented patient had "fungal rash between legs" and "skin tears with transfers". There was no care plan or interventions for integumentary status.

Upon client record review, 1 of 19 (Patient #2) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #2: On the Plan of care dated 11-2-23, the MSW frequency was listed as 1wk1, and on the plan of care dated 11-29-23, there was no frequency for the MSW, but the plan of care indicated, "MSW to evaluate patient and develop POC to be signed by MD." There was no MSW visit during the dates covered by the plans of care.

Upon patient record review, 1 of 19 (Patient #3) did not have evidence in the patient record that hospice aide assignments and duties are: • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. Patient #3: The aide care plan dated 11-2-23 showed "shower" and "bed bath" were assigned every visit. COS