Every finding on record at Garden of Angels Hospice Inc.

Observed in Record Review. In 1 of 10 patient records reviewed, the organization did not plan the patient's care by ensuring the plan of care included all services needed for the palliation and management of the terminal illness and related conditions, including medications and treatments. In RRHV#2, the patient's plan of care included both Ibuprofen and Acetaminophen prn for pain, with no clear indications for use documented (which prn analgesic to take when) . This was reveiwed and verified with the Administrator/Director of Patient Care Services.

Observed in Record Review. In 5 of 10 patient records reviewed, entries in the patient record were not appropriately authenticated and dated in accordance with the organization's policy and currently accepted standards of practice. In RRHV#1, RRHV#2, RRNHV#2, RRNHV#4, and RRNHV#5, it was noted in multiple Interdisciplinary Team (IDT) Meeting Notes, the documented updates to the hospice plan of care were not authenticated by one or more members of the IDT according to the organization's policy/process. Missing signatures and dates by the physician, RN, MSW, and/or Chaplin for their documented updates were noted in the hospice electronic record. This was reviewed and verified with the Administrator/Director of Patient Care Services.