Every finding on record at Holistic Palliative Care, Inc.

Upon patient record review, 1 of 14 (Patient 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 • Drug therapy currently associated with laboratory monitoring Patient 8 medication profile includes "Acetaminophen oral tab 325 mg 2 tabs by mouth every 6 hours prn mild pain/fever and Acetaminophen rectal suppository 650mg 1 suppository per rectum every 6 hours prn pain" with no daily dosage limit.

Upon patient record review, 1 of 14 (Patient 8) 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 8 plan of care includes "Acetaminophen oral tab 325 mg 2 tabs by mouth every 6 hours prn mild pain/fever and Acetaminophen rectal suppository 650mg 1 suppository per rectum every 6 hours prn pain" with no daily dosage limit.

Upon patient record review 4 of 14 (Patient 4, 6, 7 and 11) 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 4 MD order and plan of care noted "CHHA 2 X W"; no visits week of 8/25-8/31/24. Patient 6 MD order and plan of care noted "CHHA 3 X W". Week of 8/11-8/17/24 no visits made and week of 8/25-8/31/24 no visits made. Patient 7 MD order and plan of care noted "CHHA 2 X W"; week of 8/25-8/31/24 only 1 visit made. Patient 11 MD order and plan of care noted "CHHA 2 X W"; week of 6/30-7/6/24 and week of 7/7-7/13/24 seen 3 x w.

Upon patient client record review, 1 of 14 (Patient 14) 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 14 "Consent for Election of Medicare/Medicaid Hospice Benefit" form incomplete. The effective date of the election was "blank".