Every finding on record at Fellowship Village, Inc

Upon patient record review, 2 of 14 (Patient #5,#6) 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 5:Upon admission, the medication profile includes an entry for oxygen to be delivered at 2-5 liters per minute via nasal cannula. The order on the plan of care noted the delivery rate to be 2 liters per minute via nasal cannula. Patient 6:Upon admission, the medication profile included an entry for MiraLAX 17 gm daily. There is no evidence that the entry includes the type and amount of diluent.

Upon patient record review, 2 of 14 (Patient #5,#6) 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 5:Upon admission, the plan of care includes an order for wound care to coccyx to include cleanse with NSS, cut thin strip of hydrogel impregnated gel and gently pack wound daily. The patient resides in a skilled facility and there is no evidence of who is to perform wound care. Patient 6:Upon admission, the plan of care includes an order for MiraLAX 17 gm daily. There is no evidence that the order includes the type and amount of diluent.

Upon patient record review, 2 of 14 (Patient #3,#8) 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 3 and 8:Upon admission, patient medical record included documentation of patient use of hospital bed. The plan of care does not include hospital bed on the DME and supplies list.

Upon patient record review, 2 of 14 (Patient #5,#7) 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 5: The medical record includes nursing documentation on 11/6/23 of a blister to right heel and new orders obtained for wound care. There is no evidence of problems, goals and interventions related to wound care on the plan of care. Patient 7:The medical record includes nursing documentation on 11/13/23 that patient was having difficulty swallowing food and that the daughter was now crushing the patient's medications. There is no evidence that the physician was notified of the change of condition and any revisions were made to the plan of care.

Upon patient record review, 1 of 14 (Patient #1) did not have evidence in the patient record that hospice aide assignments and duties are: • Assigned to a specific patient by a registered nurse that is a member of the interdisciplinary group • Written patient care instructions for a hospice aide must be prepared by a Registered Nurse who is responsible for the supervision of a hospice aide as specified under paragraph (h) of 418.76 • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. The use of “PRN” or “per patient choice”, for any task, whether personal care or non-personal care tasks, are not acceptable Patient 1:Upon admission, the medical record includes nursing documentation of dysphagia and aspiration risk. Aide task of feed patient assigned and there is no evidence that the aide plan of care includes aspiration precautions.