Every finding on record at Excellent Quality Hospice Inc

Upon patient record review, 2 of 14 (Patient #2,#4) 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 2:The medication profile includes an entry for oxygen with the route as oral. COS Patient 4:The medication profile includes an entry for Voltaren topical cream. The entry does not include the location for administration.

Upon patient record review, 1 of 14 (Patient #9) 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 9: The medical record includes documentation of wounds to left ankle, right 1st toe, left trochanter, sacral region with active orders for treatment. There is no evidence of problems, goals and interventions for the provision of wound care.

Upon patient record review 2 of 14 (Patient #1,9) did not have evidence documentation in the patient record that a Registered Nurse made an on-site visit to the patient's home no less frequently than every 14 days to assess the quality of care and services provided by the hospice aide and to ensure that services ordered by the hospice interdisciplinary group meet the patient's needs. Patient 1 and 9: Patient receiving aide services. No documentation of an on site visit by a registered nurse no less frequently than every 14 days.