Every finding on record at Hospice of Natchitoches, Inc.

Based on record review and staff interview, the Hospice Agency failed to ensure controlled drugs were used safely and disposed of properly in the patient's home, as evidenced by nursing staff failing to follow the agency’s policy for 1 (#14) of 4 discharge records reviewed.Findings: --- Review of an undated policy titled “Disposal of Controlled Drug Policy” on 04/28/2026 revealed in part…In the event that you refuse to allow medications to be destroyed, the refusal is documented in your clinical record with the name and strength of the medications and the amount remaining.  Included with the documentation is your caregiver’s signature attesting to the refusal and the date your attending physician was notified of the refusal.  Further review of this policy revealed it was signed by Patient #14’s son and witnessed by a hospice RN on 10/22/2025.Review of Patient #14’s medical record revealed a start of care date of 10/22/2025 and a discharge date of 12/08/2025.Review of the discharge summary dated 12/08/2025 completed by S2DON revealed Patient #14’s hospice was revoked because the patient stated he no longer needed hospice services.  Further review revealed the family/caregiver refused to allow disposal of medications by the hospice nurse.In an interview on 04/28/2026 at 12:17 p.m., S2DON confirmed she conducted the home visit on 12/08/2025 to discharge Patient #14.  S2DON reviewed Patient #14’s record and visit note for 12/08/2025 and confirmed she did not document the name, strength, and amount of medications remaining in the home. In an interview on 04/28/2026 at 12:40 p.m., S1ADM reviewed Patient #14’s medical record and confirmed S2DON did not document the name, strength, and amount of medications remaining in the home, did not have a caregiver sign to attest the refusal of controlled medication disposal, and did not document notifying the physician of the refusal, but should have.

Based on interview and record review the Provider failed to include a detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs by failing to specify a number of prn visits in the Plan of Care for 11 (Patient #1, Patient #2, Patient #3, Patient #4, Patient #5, Patient #6, Patient #7, Patient #8, Patient #9, Patient #10, and Patient #11) of 11 sampled records reviewed. --- Findings: Review of the Providers Plan of Care-Content Policy revealed in part...Procedures: 2. b. The plan of care includes, but is not limited to: a detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs. Review of all sampled patients records revealed that skilled nurse visits were written with a frequency of 1 time a week plus unlimited prn visits. Interview on 08/08/2023 at 2:20 p.m. with S1 DON revealed all patients had orders for skilled nurse visits 1 time a week and then unlimited prn visits. S1 DON stated all other disciplines were written the same way (with unlimited prn visits). S1 DON confirmed that prn visits were not indicated on the skilled notes in the patients records, all visits were the same.