Every finding on record at Curo Health Services, LLC

Upon patient record review, 2 of 19 (Patient #2, #8) 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 therapy currently associated with laboratory monitoring Patient #2: The RN admission note dated 2-27-24, the MD CTI and the initial plan of care all indicated the patient was using O2. Oxygen was not on the medication profile. Patient #8: The plan of care dated 09-7-23 indicated the patient was using oxygen at 2L per NC. Oxygen was not on the medication profile.

Upon patient record review, 1 of 19 (Patient #10) 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 #10: Wounds were identified by the RN on 5/3/24 and they were measured, cleaned and absorbent dressing applied. The wounds were not entered into the plan of care or wound report until 6-6-24.

Upon client record review, 1 of 19 (Patient #3) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #3: Per the plan of care written on 3-25-24 the frequency of the chaplain was 2x30days. The chaplain visited 4/1, 4/15, 4/16, 4/22.

Upon patient record review, 3 of 19 (Patient #7, #8, 9) did not have evidence the hospice offers bereavement counseling that includes: • Ensuring that bereavement services reflect the needs of the bereaved • Development of a bereavement plan of care that notes the kind of bereavement services to be offered and the frequency of service delivery Patient #7: There was no evidence that the 3 month and 6 month newsletters,the support group invitation, and a phone call scheduled for 5-11-24 were completed as per the bereavement plan of care for the bereaved family member. Patient #8: There was no evidence of the 3 month and 6 month newsletter being sent according to the plan of care for the bereaved family member. Patient #9: There was no evidence of a sympathy card or Bereavement Letter #1 being sent as per the bereavement plan of care for the bereaved family member.

Upon patient record review 4 of 19 (Patient #4, #5, #6, #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#4: On 4-11-24, the aide did not document (on paper) assistance or refusal of the wheelchair according to the aide plan of care. On 4-25-24, the aide documented she socialized with the patient which was not a part of the plan of care. Patient#5: The aide frequency for the week of 1-28-24 thru 2-3-24 was 2 x week. There was only 1 visit during that week on 1-29-24. Patient#6:-The aide care plan indicated fall, universal and aspiration precautions, as well as comb hair, assist with dressing, and oral care were ordered. In the aide visit note, documented on paper, on 4-19-24, there was no evidence universal precautions were followed and on 4-29-24, the aide did not document precautions. Additionally, on visits, 4-19-24 there was no evidence oral care, dressing and comb hair were provided or refused; on 4-22-24, there was no evidence oral care was provided or refused; and on 4-29-24, there was no evidence that combing and dressing were provided or refused. Patient#10: Aide visits per the plan of care were ordered 2 x per week. On the week of 5-19-24 through 5-25-24, there was 1 visit documented on 5-23-24. Additionally, the aide, documenting on paper on 6-13-24, provided no evidence that the following activities were offered or refused as per the plan of care; turn and position, toileting, assist with feeding, empty drainage bag, or fall, aspiration and bleeding precautions.