Every finding on record at Indiana Anchor of Hope Hospice LLC

Upon patient record review, 4 of 14 (Patient #4, 6, 7, 9) did not contain evidence that a review was completed of all prescription and non-prescription medications, including herbal remedies that could affect drug therapy. Patient #4: Order date 05/31/24: Artificial Tears 1 drop "BID-twice daily eye" Did not state which eye(s). Ordered date 11/23/23: Calmoseptine 0.44-20.6% External Ointment topically "PRN-q8hr-every 8 hours as needed skin". Did not state where to apply on skin. Order date 10/29/23: Nystatin 100,000 UNIT/GM External Cream "BID-Twice Daily skin". Did not state where to apply on skin. Patient #6: Order date 12/23/25: "Triamcin Cream-Gauz Silic Tape 0.1% 2 inch PRN-BID-Twice Daily as needed transdermal". Did not state where to apply transdermal. Patient #7: Order date 10/09/25: Acetaminophen 500mg "2 tablets q8hr give 2 tables by mouth every 8 hours" and "Acetaminophen 650mg Rectal Suppository 1 suppository PRN-q4hr-every 4 hours a needed". There was no maximum dose listed. Voltaren Arthritis Pain 1% External Gel "thin layer QID-Four Times Daily topical Apply thin layer to arthritic areas 4 times a day". There was no indication to what arthritic areas. Order date 01/21/26: Xdemvy 0.25% Ophthalmic Solution "1 drop q12hr-every 12 hours eye one drop in affected eye every 12 hours for 6 weeks". Did not indicate which eye was affected. Patient #9: Order date 11/15/24: Diclofenac gel 1% "PRN-QID- Four times Daily As Needed affected area Max 32GM a day". Did not state where to apply.

Upon patient record review, 4 of 14 (Patient #4, 6, 7, 9) 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 #4: POC/Order date 05/31/24: Artificial Tears 1 drop "BID-twice daily eye" Did not state which eye(s). Ordered date 11/23/23: Calmoseptine 0.44-20.6% External Ointment topically "PRN-q8hr-every 8 hours as needed skin". Did not state where to apply on skin. POC/Order date 10/29/23: Nystatin 100,000 UNIT/GM External Cream "BID-Twice Daily skin". Did not state where to apply on skin. Patient #6: POC/Order date 12/23/25: "Triamcin Cream-Gauz Silic Tape 0.1% 2 inch PRN-BID-Twice Daily as needed transdermal". Did not state where to apply transdermal. Patient #7: POC/Order date 10/09/25: Acetaminophen 500mg "2 tablets q8hr give 2 tables by mouth every 8 hours". Acetaminophen 650mg Rectal Suppository 1 suppository PRN-q4hr-every 4 hours a needed". There was no maximum dose listed. Voltaren Arthritis Pain 1% External Gel "thin layer QID-Four Times Daily topical Apply thin layer to arthritic areas 4 times a day". There was no indication to what arthritic areas. Order date 01/21/26: Xdemvy 0.25%b Ophthalmic Solution "1 drop q12hr-every 12 hours eye one drop in affected eye every 12 hours for 6 weeks". Did not indicate which eye was affected. Patient #9: POC/Order date 11/15/24: Diclofenac gel 1% "PRN-QID- Four times Daily As Needed affected area Max 32GM a day". Did not state where to apply.

Upon observation, there was no evidence the annual report documents the use of volunteers providing day to day administrative and/or direct patient care services in an amount that, at a minimum, equals 5 percent of the total patient care hours of all paid hospice employees and contract personnel. For calendar year 2025 volunteer total was only 1.21%.

Upon observation, there was no evidence of contracts/agreements with other facilities/agencies/hospices to receive patients in the event the hospice cannot provide care to their patients during an emergency.

Upon patient record review, 2 of 11 (Patient #1, 5) 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 Patient 1: The medication list indicates natural tears gtts 1-2 gtts tid PRN for dry eyes; there is no indication of which eye(s) the drops are to be used in. (corrected onsite) Patient 5: The medication list indicates natural tears gtts 1-2 gtts qid PRN for dry eyes; there is no indication of which eye(s) the drops are to be used in. (corrected onsite)

Upon patient record review, 5 of 11 (Patient #1, 2, 3, 9, 10) 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 patient has a hoyer lift for management of the terminal illness; however, this DME does not appear on the plan of care. (corrected onsite) Patient 2: The patient has a shower bench for management of the terminal illness; however, this DME does not appear on the plan of care. (corrected onsite) Patient 3: The patient has a wheelchair for management of the terminal illness; however, this DME does not appear on the plan of care. (corrected onsite) Patient 9: The patient has a hospital bed, OTB table, oxygen concentrator, and fall mat for management of the terminal illness; however, this DME does not appear on the plan of care. Patient 10: The patient has a hospital bed, OTB table, oxygen concentrator, and fall mat for management of the terminal illness; however, this DME does not appear on the plan of care.