Every finding on record at Edem Hospice Inc

Upon patient record review, 5 of 14 (Patient #1, 2, 4, 6, 9) 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 Patient 1: The medication list indicates lidocaine 5% topical patch apply 1 patch 12 hours on, 12 hours off PRN pain; however, there is no specification of the location for use. (corrected onsite) Patient 2: The medication list indicates Dorzolamide HCl 20mg 1 drop daily; however, there is no specification of which eye(s) for use. (corrected onsite) Patient 4: The medication list indicates diclofenac 1% 2g topical bid; however, there is no specification of the location for use. (corrected onsite) Patient 6: The medication list indicates diclofenac 1% 4g topical daily; however, there is no specification of the location for use. Also, the medication list indicates move free ung topical q 6 hours PRN arthritis pain. This is an incomplete entry as it does not include the name of the medication, the dosage, or the quantity for use and drug interactions cannot be verified. (corrected onsite) Patient 9: The medication list indicates Latanoprost 0.005% 1 gtt daily; however, there is no specification of which eye(s) for use. (corrected onsite)

Upon patient record review, 1 of 14 (Patient #6) did not have evidence that the plan of care includes all services necessary for the palliation and management of the terminal illness and related conditions which including interventions to manage pain and symptoms. Patient 6: On 07.01.2024, the patient had an Xray of the right hand with negative findings/results. There is no evidence in the patient record of a complaint related to the right hand during scheduled visits, and no phone calls/communication notes or PRN visits were recorded in the recent vicinity of this test. There was no evidence of a physician order for the Xray. There was no evidence of communication between the IDT or with the patient/family regarding the test results.

Upon patient record review, 5 of 14 (Patient #1, 2, 4, 6, 9) 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 plan of care indicates lidocaine 5% topical patch apply 1 patch 12 hours on, 12 hours off PRN pain, but does not specify the location for use. (corrected onsite) Patient 2: The plan of care indicates Dorzolamide HCl 20mg 1 drop daily, but does not specify which eye(s) for use. (corrected onsite) Patient 4: The plan of care indicates diclofenac 1% 2g topical bid, but does not specify the location for use. Also, the plan of care indicates oxygen 2 LPM, may increase to 5 LPM PRN for comfort, but does not specify the route for oxygen administration. (corrected onsite) Patient 6: The plan of care indicates diclofenac 1% 4g topical daily, but does not specify the location for use. (corrected onsite) Patient 9: The plan of care indicates Latanoprost 0.005% 1 gtt daily, but does not specify which eye(s) for use. Also, the plan of care indicates oxygen 2 LPM, may increase to 5 LPM PRN for comfort, but does not specify the route for oxygen administration. (corrected onsite)

Upon patient record review 1 of 14 (Patient #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 10: The patient was admitted for hospice services on Monday, 05.06.2024; the hospice aide visit frequency was to begin at 2 x weekly as of the admission date, 05.06.2024. However, during the first week of hospice admission, the hospice aide only visited the patient 1 time, on 05.10.2024.

Upon client record review, 1 of 14 (Patient #12) did not have evidence that if a patient revokes the election of hospice care or is discharged from hospice in accordance with §418.26, the hospice must forward to the patient's attending physician: • A copy of the hospice discharge summary • The patient's clinical record, if requested Patient 12: There was no evidence of a completed discharge summary for this patient who revoked hospice services.