Every finding on record at Echo Hospice of Pennsylvania, LLC

Upon patient record review, 8 of 19 (Patient #1,2,3,4,5,6,7,14) 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 #1,2,3,4,5,6,7,14-Admission orders include O2 2L per NC continuously for shortness of breath. Oxygen is not listed on the medication profile. #5-Medication profile lists Mupirocin 2% 1 x day every 2 days. There is no location included in the order.

Upon patient record review, 1 of 19 (Patient #5) did not have evidence that a Registered Nurse is designated to ensure continuous assessment of the patient and family's needs and to coordinate activities with other members of the interdisciplinary group (IDG). The IDG must work together and is responsible for supervision of the care and service for each patient and family. #5-Wound care ordered on 12/19/24 as follows: Right foot wound, 2nd toe, cleanse with wound cleanser and pat dry, apply triple antibiotic ointment, wrap with gauze daily. There is no evidence in the chart that the wound was assessed or wound care provided after the start date of the order.

Upon patient record review, 1 of 19 (Patient #4) did not have evidence that all entries are legible, clear, complete, and appropriately authenticated and dated in accordance with the organizations policies and procedures and currently accepted standards of practice. Electronic signatures are acceptable as long the hospice is following appropriate safeguards to prevent unauthorized access to the patient records. #4-Wound care orders dated 12/30/24 as follows: D/C previous wound care orders. Wound care to sacrum: cleanse with NSS,apply Medihoney and calcium alginate to base of wound, secure with border gauze daily and prn if soiled or dislodged. Facility nurse may perform wound care in absence of hospice nurse. Wound care to left heel: cleanse with NSS and pat dry, apply nickel sized amount of Santyl to wound base, cover with dry 4X4, rolled gauze, and secure with tape daily and prn if soiled or dislodged. Facility nurse may perform wound care in absence of hospice nurse. Nursing notes from 1/3/25 and 1/7/25 state "wound care provided"-there is no detail.

Upon patient record review, 1 of 19 (Patient #5) did not have evidence that a written hospice plan of care is established and maintained in consultation with SNF/NF or ICF/IID representatives. All hospice care provided is in accordance with this hospice plan of care. #5-Wound care ordered on 12/19/24 as follows: Right foot wound, 2nd toe, cleanse with wound cleanser and pat dry, apply triple antibiotic ointment, wrap with gauze daily. There is no evidence in the chart that the wound was assessed or wound care provided after the start date of the order. Documentation on 12/23/24 states skin is intact and there is no breakdown, but there is no order showing the wound was healed or wound care was discontinued.