Every finding on record at Needles Hospice, Inc.

Upon patient record review, 5 of 6 records (Patient #1, #2, #3, #4, #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. Patient 1: The medication profile contains 10 PO medications with no route included. Corrected on site. Patient 2: The medication profile contains 8 PO medications with no route included. Corrected on site. Patient 3: The medication profile contains 10 PO medications with no route included. Corrected on site. Patient 4: The medication profile contains 11 PO medications with no route included. Patient 5: The medication profile contains 16 PO medications with no route included.

Upon patient record review, 2 of 2 applicable records (Patient #4, #5) did not have evidence in the patient record that the comprehensive assessment includes a bereavement component. Patient 4 and 5: Missing evidence of an initial bereavement assessment completed as part of the comprehensive assessment.

Upon patient record review, 2 of 2 applicable records (Patient #4, #5) did not have evidence the hospice offers bereavement counseling which includes a bereavement plan of care outlining services to be received. Patient 4: There is a bereavement assessment at time of death, no evidence of a care plan of follow up for bereavement in the record. Patient 5: There is a bereavement assessment at time of death, no evidence of a care plan of follow up for bereavement in the record.

Upon patient record review, 6 of 6 records (Patient #1, #2, #3, #4, #5, #6) did not have evidence that the medical director or physician designee provides written certification that it is anticipated that the patient's life expectancy is 6 months or less if the illness runs its normal course. Patient 1,2,3,4,5: There was a document titled: "Physician certification for Hospice benefit", this document contains no narrative nor attestation. There was no evidence of Physician certification. Patient 6: There was a document titled: "Physician certification for Hospice benefit", this document contains a brief narrative, no evidence of an attestation.