Every finding on record at Healing Path Hospice Centers of Texas LLC

Upon patient record review, 2 of 9 (Patient #3,#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. 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 #3: The medication profile included 17gm of MiraLAX without evidence of a diluent. Additionally, the comprehensive assessment dated 10-08-25 indicated the patient was using O2 at 2L per NC, but oxygen was not listed on the medication profile. Patient #4: The plan of care indicated an oxygen concentrator, E-tanks and a regulator were ordered, however, oxygen was not listed on the medication profile.

Upon patient record review, 1 of 9 (Patient #4) 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 #4: The patient's hospice diagnosis was small cell lung cancer, however, there was no evidence of a care plan for respiratory on care plans dated 10-09 and 10-23-25.

Upon patient record review, 2 of 9 (Patient #3, #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 #3: The comprehensive assessment dated 10-08-25 indicated the patient was using 2L of O2 per NC, however, there was no order for oxygen. Patient #4: The comprehensive assessment dated 10-07-25 indicated the patient was using room air at 2L per NC and the plan of care dated 10-09-25 indicated an oxygen concentrator, E-tanks and a regulator were ordered, but there was no order for oxygen administration.

Upon patient record review, 2 of 9 (Patient #3,#8) 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 #3: The comprehensive assessment indicated the patient was using 2L of O2 per NC, but there was no evidence of oxygen precautions on the aide care plan which was dated 10-08-25. Patient #8: There was an order for O2 at 2LPM written on 09-30-25, but there was no evidence the aide assignment completed on 10-01-25 included oxygen precautions.

Upon patient client record review, 3 of 9 (Patient #2,#4,#8) did not have evidence that each patient record contains: • Signed copies of the notice of patient rights in accordance with 418.52 • Signed election statement in accordance with 418.24 Patient #2: The Hospice Election, Informed Consent signed 10-09-25 had no evidence of an effective date for the Medicare Hospice Benefit. Patient #4: The Hospice Election, Informed Consent signed 10-07-25 had no evidence that liability of payment was addressed. Patient #8: The Hospice Election, Informed Consent Acknowledgement signed 09-30-25 documented that the patient had both declined and requested the addendum for non-covered items, services and drugs. There was no evidence of an addendum.

Upon personnel record review, 1 of 11 (Personnel #11) did not have evidence that all Speech Therapy Services are provided by a qualified licensed Speech-Language Pathologist (SLP) or Audiologist in accordance with the state's Speech-Language Pathology Practice Act and the hospice's policies and procedures and/or job descriptions. Patient #11: The contracted staffing agency refused to provide a personnel file for the ST unless agency needed to use the staff member.

Upon personnel record review, 1 of 11 (Personnel #10) did not have evidence all Occupational Therapy Services are provided by a qualified licensed Occupational Therapist (OT) in accordance with the state's Occupational Therapy Practice Act and the hospice's policies and procedures and/or job descriptions. Personnel #10: The staffing agency refused to provide a personnel file for the OT unless the agency needed the service.

Upon personnel record review, 2 of 11 (Personnel #10,11) did not have evidence the hospice obtained a criminal background check on all contracted individuals who have direct patient care and access to patient records. Personnel #10,11: The staffing agency refused to provide a personnel file for the OT, ST unless the agency needed the service. No evidence of a criminal background check completed.