Every finding on record at Emerald First Choice Hospice LLC

Upon patient record review, 5 of 19 (Patient 2, 3, 6, 8, and 13) 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 Upon patient record review, 6 of 19 (Patient 2, 3, 6, 8, 13, 14) 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 2 was admitted on 5/15/23 with a diagnosis of Sarcopenia. Review of medication profile revealed patient was prescribed a total of 29 medications including supplements. 21 medications did not include an indicator for use. Polyethylene Glycol 3350 17 gm/scoop 1 x daily did not include a diluent. Patient 3 was admitted on 6/23/23 with a diagnosis of CHF. Review of medication profile revealed an order for Lantiseptic 0.45-20% ointment 3 x daily and as needed (PRN) and Calmoseptine 0.44/20.6% BID. There was no site or indicator listed on the profile. Patient 6 was admitted on 4/6/23 with a diagnosis of COPD. Review of medication profile revealed Bactroban topical 20% 7 x daily. There was no site or indicator on the profile. Patient 8 was admitted on 5/30/23 with diagnosis of Heart Failure. Review of medication profile revealed the following medications that had no indicator for use. Buspirone HCL 10 mg 1 tab po TID, Namenda 5 mg po BID, Eliquis 2.5 mg 1 tab po BID, Losartan Potassium 100 mg 1 tab po QD and Potassium Chloride ER 20 MEQ 1 tab po Q day. Lasix 40 mg 1 tab oral had no frequency. Patient 13 was admitted to the hospice on 5/10/23 with a diagnosis of Malignant Neoplasm of Esophagus. Review of medication profile revealed Lantiseptic cream Multi Purpose 0.45 - 20%. Apply topically 3 x day and PRN to sacrum. There was no indicator for use.

Upon patient record review, 1 of 19 (Patient 13) 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 13 admitted to the hospice on 5/10/23 with a diagnosis of Malignant Neoplasm of Esophagus. Patient had a Right Upper Quadrant PEG tube. Plan of care did not include goals and interventions for the care and management of the PEG tube.