Every finding on record at Heartland Hospice LLC

Upon patient record review, 1 of 14 (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. 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 4: The medication profile included entries for polyethylene glycol 17 mg po daily prn and Clear Lax 17 mg po daily prn which is also polyethylene glycol. There is duplication of drug therapy.

Upon patient record review, 2 of 14 (Patient #9,#11) 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 9: The medical record contains nursing documentation upon admission that the patient was admitted post hospitalization for sepsis and that sepsis remains as a co-morbidity. There is no evidence that the plan of care includes problems, goals or interventions for current infection/sepsis. Patient 11: The medical record contains nursing documentation upon admission that the patient is exhibiting signs and symptoms of imminence. There is no evidence that the plan of care includes problems, goals or interventions for imminence.

Upon patient record review, 2 of 14 (Patient #1, #2) 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 equipment and supply needs. Patient 1:The medical record includes documentation on admission that the patient's supply needs include ostomy care supplies. There is no evidence that ostomy supplies are included on the plan of care. Patient 2:The medical record includes documentation on admission that the patient's equipment and supply needs include a wheelchair and catheter supplies. There is no evidence of a wheelchair or catheter supplies on the plan of care.