Every finding on record at Integracare of Athens-Hospice, LLC

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: The medication profile contained oxygen with no instructions for appropriate delivery method. Corrected on site.

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: The medical record contained an order for oxygen with no instructions for appropriate delivery method. Corrected on site.

Upon patient record review, 3 of 14 (Patients #5,#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 equipment and supply needs. Patient 5: The medical record contained nursing documentation upon admission identifying patient use of a walker and shower chair. There was no evidence of the walker and shower chair included as DME in the plan of care. Corrected on site. Patient 7: The medical record contained nursing documentation upon admission identifying patient use of a hospital bed and over the bed table. There was no evidence of the bed and table included as DME in the plan of care. Corrected on site. Patient 9: The medical record contained nursing documentation upon recertification visit 6/12/23 identifying patient use of a hospital bed. There was no evidence of the bed included as DME in the plan of care. Corrected on site.

Upon observation, there was no evidence the hospice follows acceptable standards of practice to prevent the transmission of infections and communicable diseases, including standard precautions. Patient 2: Upon observation during the home visit, the RN broke bag technique protocol utilizing a table for setting bag and vitals equipment without cleansing or utilizing a barrier. The RN was also observed placing equipment back into the bag without cleansing after use.

Upon patient record review, 1 of 14 (Patient #12) did not have evidence the hospice offers bereavement counseling that includes: • Making bereavement services available to the family and other individuals in the bereavement plan of care up to 1 year following the death of the patient. Bereavement counseling also extends to residents of a SNF/NF or ICF/IID when appropriate and identified in the bereavement plan of care • Ensuring that bereavement services reflect the needs of the bereaved • Development of a bereavement plan of care that notes the kind of bereavement services to be offered and the frequency of service delivery Patient 12: The bereavement care plan contained tasks for the bereaved to receive regular mailings at three and six months. There was no evidence of the bereaved receiving the mailings.

Upon patient client record review, 1 of 14 (Patient #10) did not have evidence that each patient record contains: • Signed election statement in accordance with 418.24 Patient 10: The election of benefit form identifies the patient elected to receive the notification of non-covered items. There was no evidence the patient received the addendum.