Every finding on record at Da Vinci Hospice Care Inc

Upon patient record review, 1 of 14 (Patient #1) 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 #1-Medication profile dated 6/2/25 contains Tylenol 500 mg 1 every 6 hours for mild pain, not to exceed 3000mg in 24 hrs and Tylenol 650 mg every 6 hrs for mild to moderate pain. There are not specific directions for when to one vs the other as both contain for "mild" pain and there could be a potential for duplication. Maximum dosage should be specified for all acetaminophen products.

Upon patient record review, 1 of 14 (Patient #5) did not have evidence in the patient record that the comprehensive assessment includes a bereavement component which includes the needs of the patient's family and other individuals focusing on the social, spiritual, and cultural factors that may impact their ability to cope with the patient's death. Information gathered from the initial bereavement assessment is incorporated into the plan of care and is considered in the bereavement plan of care. #5-There is no evidence of an initial bereavement assessment.

Upon patient record review, 1 of 14 (Patient #3) 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. #3-The comprehensive assessment and physician narrative state that the primary diagnosis for this patient is Parkinsonism with a secondary diagnosis of hemiplegia. Neither of these diagnoses are on the current plan of care dated 05/24/25 or any of the previous care plans. The primary diagnosis since the start of care has been heart disease. There are no goals or interventions for these diagnoses.

Upon client record review, 1 of 14 (Patient #5) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. #5-The plans of care dated 03/17/25 and 06/15/25 lists O2 2 lpm via nasal cannula. The nursing notes from 03/18/25 and 06/17/25 state the O2 may be increased from 2-5 lpm to maintain O2 sat above 91%. There are no orders for the oxygen to be titrated.

Upon patient record review, 2 of 5 (Patient #1, 2) 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. Patient #1 The patient has Ibuprofen 600 mg BID listed on the medication profile, but the patients medication bottle reads 1 pill every 8 hours as needed for pain. The patient has multiple medications in the home that are not listed on the medication profile including diclofenac, escitalopram, Jentadueto, losartan, Imitrex, meclizine and 8-10 other medications. Patient #2 Patient has medications not included on the medication profile including losartan, glimeperide, Tradjenta, rosuvastatin, Rybelsus, gabapentin and Vit D.

Upon patient record review, 2 of 5 (Patient #1, 2) 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 The patient has Ibuprofen 600 mg BID listed on the plan of care, but the patients medication bottle reads 1 pill every 8 hours as needed for pain. The patient has multiple medications in the home that are not listed in the POC including diclofenac, escitalopram, Jentadueto, losartan, Imitrex, meclizine and 8-10 other medications. Patient #2 Patient has medications not included in the POC including losartan, glimeperide, Tradjenta, rosuvastatin, Rybelsus, gabapentin and Vit D.