Every finding on record at Noble Life Hospice Inc

Upon patient record review, 1 of 14 (Patient #13) 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 13: The medication list recorded, "Fleet enema Saline, gently insert enema tip into rectum, squeeze bottle until the majority of the drug is inside your rectum." There was no further clarification on the frequency the enema should be administered.

Upon patient record review, 1 of 14 (Patient #13) 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 13: The plan of care effective at the time of death recorded, "Fleet enema Saline, gently insert enema tip into rectum, squeeze bottle until the majority of the drug is inside your rectum." There was no further clarification on the frequency the enema should be administered.

Upon patient record review 2 of 14 (Patient #3, 7) did not have evidence documentation in the patient record that a Registered Nurse made an on-site visit to the patient's home no less frequently than every 14 days to assess the quality of care and services provided by the hospice aide and to ensure that services ordered by the hospice interdisciplinary group meet the patient's needs. Patient 3: The EMR did not contain evidence of an aide supervisory visit from the initiation of the service on 09/09/25 through the last registered nurse visit completed on 10/30/25. The agency verified there was no paper form completed for this task and the supervisory visit should be completed within the supervisory section of the nursing assessment. Patient 7: The EMR did not contain evidence of an aide supervisory visit from the initiation of the service on 07/21/25 through the last registered nurse visit completed on 10/28/25.

Upon patient client record review, 1 of 14 (Patient #1) did not have evidence that each patient record contains: • Signed copies of the notice of patient rights in accordance with 418.52 • Signed election statement in accordance with 418.24 Patient 1: The Election Statement present in the patient record did not record an effective date for authorized benefits under the "Effective Dates/Benefit Period" section of the document.

Upon personnel record review, 1 of 1 applicable (Personnel #6) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: (This standard applies to all Hospice Aides providing care/service who are directly employed by the hospice or through a contractual agreement.) ·(C) Shampoo, sink, tub, and bed The other subject areas in this section may be evaluated through written examination, oral examination or after observation of a Hospice Aide with a patient. Personnel Record #6: The competency list utilized by the agency at this time, does not differentiate the types of shampoo, therefore competency for shampoo at sink, tub, bed cannot be validated.