Every finding on record at Eclipse Hospice Care, Inc

Upon patient record review, 1 of 5 records (Patient #3) 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 3: medication profile included Diclofenac sodium topical gel 1% 1 app topical- apply 2 GM to affected area 4x day for joint pain not to exceed 32 GM per day. There was no evidence for an area to apply. Corrected on site.

Upon patient record review, 5 of 5 records (Patient #1, #2, #3, #4, #5) 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 1: RN on SOC documented mild psychosocial distress. SW SOC assessment documented Mild anxiety, mild psychosocial distress, assessment for Recert dated 2/9/2022 documented mild anxiety by family. There was no evidence of a care plan for psychosocial distress/anxiety. Corrected on site. Patient 2: RN on SOC documented mild psychosocial distress. SW SOC assessment documented Mild anxiety, mild psychosocial distress. There was no evidence of a care plan for psychosocial distress/anxiety. There was no evidence of a care plan addressing psychosocial or spiritual distress/anxiety. Corrected on site. Patient 3: SW SOC assessment documented Mild anxiety, faith tested, concern of afterlife. Recert assessment by MSW 1/8/2022 documents mild anxiety. There was no evidence of a care plan for psychosocial distress/anxiety. Corrected on site. Patient 4: RN on SOC documented mild psychosocial distress. SW SOC assessment documented Mild anxiety, mild psychosocial distress, caregiver mild anxiety. There was no evidence of a care plan for psychosocial/anxiety. Patient 5: RN on SOC documented mild psychosocial distress. SW SOC assessment documented Mild anxiety, mild psychosocial distress. There was no evidence of a care plan for psychosocial distress/anxiety.

Upon patient record review, 1 of 5 records (Patient #3) 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 3: Order dated 10/11/2021 and renewed 3/9/2022 includes Diclofenac sodium topical gel 1% 1 app topical- apply 2 GM to affected area 4x day for joint pain. Not to exceed 32 GM per day. There was no evidence for an area to apply. Corrected on site.