Every finding on record at Guiding Light Hospice SW, LLC

It is required that the documented comprehensive assessment includes a drug profile that contains the patient's current prescription and over the counter (OTC) drugs, supplements, herbal remedies, and other alternative treatments that could affect drug therapy. The medication review process includes the identification of the following: the effectiveness of drug therapy, drug side effects, actual or potential drug interactions, duplicate drug therapy, and drug therapy associated with laboratory monitoring. The assessment includes evidence that common side effects of medication in the hospice populations are anticipated, and as appropriate, preventive measurements are implemented to manage the side effects. The drug profile is updated per the hospice policy and procedure, but, at minimum, at the time of each comprehensive assessment and/or when new medication is added, or changes are made to existing medication. This standard was not met as evidenced by document review, clinical record review, observation, and interview. In 2 of 3 (67%) home visits observations, the agency did not ensure the medication profile was updated as required by agency policy. Agency policy No. 2-004 Medication Profile, required in part, “The medication profiles will be updated for each change to reflect current medications, and new and/or discontinued medications." Clinical Record 1/Home Visit 1: The patient elected the hospice benefit 10/14/2024 with a terminal diagnosis of chronic obstructive pulmonary disease. During the home visit observation on 02/26/2025 with the Chaplain (Personnel Record 1), a medication review was completed by comparing the patient’s current home medications to the hospice medication profile printed on 02/25/2025. The hospice medication profile included Ondansetron 4 mg oral tablet, disintegrating take 1 tablet every 8 hours as needed for nausea or vomiting. The patient's bottle of Ondansetron included instructions for the patient to take Ondansetron daily. The patient was prescribed Diphenhydramine 25 mg two times a day per the bottle in the home and the patient confirmed he/she takes the medication. The hospice medication profile did not include Diphenhydramine. The hospice medication profile included Senna 8.6 mg take by mouth 2 times a day. The instructions on the bottle of Senna directed the patient to take the medication 3 times a day. Clinical Record 2/Home Visit 2: The patient elected the hospice benefit 02/22/2025 with a terminal diagnosis of senile degeneration of the brain. During the home visit observation on 02/26/2025 with the Licensed Medical Social Worker (Personnel Record 2), a medication review was completed by comparing the patient’s current home medications to the hospice medication profile printed on 02/25/2025. The hospice medication profile included Haloperidol 0.5 mg oral tablet, take 0.5 milligrams every six hours for six days as needed for agitation. The instructions on the patient's Haloperidol bottle directed the patient to take the medication for up to 5 days. The Compliance Specialist, who was present for the home visit observations on 02/26/2025, confirmed that the hospice medication profiles did not include the patient’s current medications.