Every finding on record at Heights' Hospice Care, LLC.

Upon patient record review, 2 of 8 (Patient #1, 2) 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 #1 -Medication profile indicated all medication routes as oral but all medications were per g-tube. Patient #2 - Medication profile indicated all medication routes as oral but all medications were per g-tube.

Upon patient record review, 2 of 8 (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 medications and treatments. Patient #1 -The POC 11/20/2021 indicated medications route as oral but all medications were per g-tube. Patient #2 -The POC 11/21/2021 indicated medications route as oral but all medications were per g-tube.

Upon client record review, 3 of 8 (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 - POC dated 11/20/2021did not contain order for g-tube feedings amount or flushing of tube. Patient #2 - POC dated 11/21/2021 did not contain order for g-tube feedings amount or flushing of tube. Patient #3 - POC dated 01/14/2022 - did not contain order for UA and C&S obtained on admission visit.

Upon patient record review 1 of 3 applicable patients (Patient #2) 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 #2 - Aide provided the following tasks: cleaning nails, comb hair, oral swabs every visit between 11/29/2021 - 01/20/2021, but this tasks are not on the aide care plan.