Every finding on record at Golden Age Hospice Care Inc.

Upon patient record review, 4 of 14 (Patient #4, 6, 7, 8) 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 Patient 4, 6, 7, 8: The patient's oxygen did not appear on the medication list. (corrected onsite)

Upon patient record review, 3 of 14 (Patient #1, 2, 3) did not have evidence the plan of care must includes all services necessary for the palliation and management of the terminal illness and related conditions, including the following: • A detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs • The IDG demonstrates a proactive approach in developing each patient's plan of care by planning ahead for anticipated patient changes and needs. Decisions should reflect the patient/family preferences rather than be solely a response to a crisis. Patient 1, 2, 3: Discipline orders for the MSW are written as 1 visit for initial assessment + 1 extra visit per benefit period per family/caregiver request for crisis management. (corrected onsite)

Upon client record review, 3 of 14 (Patient #1, 2, 3) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient 1: The patient was admitted for hospice services on 01.27.2024. The MSW visited in January to perform an initial assessment. Orders were entered for only PRN visits thereafter; however, the MSW made monthly visits on 02.27.2024 and 03.26.2024 without a physician's order for these visits. Patient 2: The patient was admitted for hospice services on 02.03.2024. The MSW visited in February to perform an initial assessment. Orders were entered for only PRN visits thereafter; however, the MSW made monthly visits on 03.03.2024 and 04.02.2024 without a physician's order for these visits. Patient 3: The patient was admitted for hospice services on 01.27.2024. The MSW visited in January to perform an initial assessment. Orders were entered for only PRN visits thereafter; however, the MSW made monthly visits on 02.27.2024 and 03.26.2024 without a physician's order for these visits.

Upon patient record review and direct observation 1 of 14 (Patient #3) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient 3: According to the hospice aide care plan, it was not indicated that the aide should check the patient's vital signs; however, during the home visit the aide was observed checking and recording the patient's vital signs prior to proceeding with personal care tasks. (corrected onsite)