Every finding on record at Geiss Med Hospice Id LLC

Observed in Record Review. On 6 of 10 active patient records reviewed, the plan of care had standing orders that were not consistent with assessed clinical needs. On RRHV #1, RRNHV #1, RRNHV #4, and RRNHV #5, it was noted that there were orders for wound care but the patient has had no active wounds while on service. On RRNHV #2 and RRNHV #6, it was noted that patient has an active wound with orders for care of those wounds but there is a standing order for PRN wounds that may develop. This finding was reviewed with the DCPS.

Observed in Record Review. On 1 of 10 active patient records reviewed, treatment was provided according to the plan of care. On RRHV #1, it was noted during the home visit that the patient was on 7L of oxygen, however the orders on the Plan of Care were for 1-5L of oxygen. This finding was reviewed with the DCPS.

Upon patient record review, 1 of 10 (Patient #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. Patient #4 -The medication profile included latanoprost 0.05% eye drops but did not indicate which eye or eyes for administration.

Upon patient record review, 1 of 10 (Patient #1) 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 #1- The patient had a diagnosis of severe protein calorie malnutrition and the comprehensive assessment indicated the patient had a poor appetite with significant weight loss and was taking aspirin. The plan of care did not include interventions and goals related to nutrition or bleeding risk/precautions.

Upon patient record review, 2 of 10 (Patient #2, 4) 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- The plan of care included an order for management of the catheter but did not include the size of the catheter or the frequency of changes necessary. Patient #4- The plan of care included an order for latanoprost 0.05% eye drops but did not indicate which eye or eyes for administration.