Every finding on record at Eden Hospice at King County, LLC

Upon patient record review, 1 of 14 (Patient #1) 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 equipment and supply needs. Patient 1:Per nursing documentation, patient currently using heel protectors. There is no evidence of heel protectors in the plan of care.

Upon patient record review, 1 of 14 (Patient #9) did not have evidence that a revised plan of care includes information from the patient's updated comprehensive assessment and must note the patient's progress towards outcome/goals from the plan of care. Patient 9:Upon medical record review, nursing documentation noted that patient had frequent episodes of straining during BM's and order obtained to increase senna from one tablet daily to 2 tablets. No evidence of Problems, Goals and Interventions for Constipation. Nursing documentation of chronic insomnia requiring increase in mirtazapine dose, No evidence of Problems, Goals and Interventions for insomnia.

Upon patient record review 1 of 14 (Patient #3) 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 3:The aide plan of care included the frequency of visits as 1 week 1, 2 week 12. There is no evidence of aide visits documented in the patient's record for week 1.

Upon patient client record review, 1 of 14 (Patient #6) 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. Patient 6: The medical record included documentation in narrative of nursing visit on 12/1/23 that patient was on oxygen therapy at 1 liter per minute via nasal cannula due to continued shortness of breath however, the vital sign section recorded for the same visit indicated that the patient was on room air. It was confirmed with the Director of Patient Care Services that the patient was using continuous oxygen at 1 liter per minute.