Every finding on record at Naars Hospice, Inc.

Upon patient record review, 1 of 11 (Patient #10) 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 #10: The medication profile contained diclofenac sodium gel 1% topical without evidence of location to be applied. In addition, there was an order for hydrocortisone 1% topically twice a day PRN for inflammation however, this was not listed on the medication profile.

Upon patient record review, 1 of 11(Patient #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 medications and treatments. Patient #10: There were orders for diclofenac sodium gel 1% topical PRN for rheumatoid arthritis and hydrocortisone 1% topically twice a day PRN for inflammation however, there was not evidence of location to be applied.

Upon patient record review, 1 of 11 (Patient #11) 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 #11: There was no evidence that bereavement services were extended to family.

Upon contract review, SNF Fountainview inpatient contract did not have evidence that the hospice patient's inpatient clinical record includes a record of all inpatient services furnished and events regarding care that occurred at the facility; that a copy of the discharge summary be provided to the hospice at the time of discharge; and that a copy of the inpatient clinical record is available to the hospice at the time of discharge. corrected on site

Upon contract review, SNF Fountainview inpatient contract did not have evidence that the inpatient facility has identified an individual within the facility who is responsible for the implementation of the provisions of the agreement. corrected on site