Every finding on record at Olive Grove Hospice LLC

Upon patient record review, 3 of 19 (Patient #2, 3, 11) 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 2: The medication list entry for olanzapine 2.5mg indicates 1 tab po bid PRN, no evidence of the reason for use of this PRN medication. (corrected onsite) Patient 3: The medication list entry for ammonium lactate 12% topical cream indicates apply 1 gram daily, no evidence of a location for use. (corrected onsite) Patient 11: The medication list entry for lorazepam 0.5mg indicates 1 tab po q 4 hours PRN, no evidence of the reason for use of this PRN medication. (corrected onsite)

Upon patient record review, 2 of 19 (Patient #6, 7) 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 6: The patient has DuoNeb ordered via nebulizer; however, the plan of care does not include the nebulizer as a part of ordered DME. (corrected onsite) Patient 7: The patient has albuterol and DuoNeb ordered via nebulizer; however, the plan of care does not include the nebulizer as a part of ordered DME. (corrected onsite)

Upon client record review and direct observation during the home visit, 7 of 19 (Patient #1, 4, 6, 7, 8, 9, 14) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient 1: The plan of care indicates the MSW will visit the patient 1 x weekly. However, during the weeks of 08.18.2024, 08.25.2024, and 09.01.2024, there was no evidence that the MSW completed a visit to the patient; there was also no indication of a missed visit by the MSW on those weeks. Patient 4: The plan of care indicates the MSW will visit the patient 1 x weekly. However, during the weeks of 08.18.2024 and 09.01.2024, there was no evidence that the MSW completed a visit to the patient; there was also no indication of a missed visit by the MSW on those weeks. Patient 6: The plan of care indicates the MSW will visit the patient 1 x weekly. However, during the weeks of 08.18.2024, 08.25.2024, and 09.01.2024, there was no evidence that the MSW completed a visit to the patient; there was also no indication of a missed visit by the MSW on those weeks. Patient 7: The plan of care indicates the MSW will visit the patient 1 x weekly. However, during the weeks of 08.18.2024, 08.25.2024, and 09.01.2024, there was no evidence that the MSW completed a visit to the patient; there was also no indication of a missed visit by the MSW on those weeks. Patient 8: The plan of care indicates the MSW will visit the patient 1 x weekly. However, during the week of 07.28.2024, there was no evidence that the MSW completed a visit to the patient; there was also no indication of a missed visit by the MSW on this week. Additionally, the plan of care indicates the chaplain will visit the patient 1 x weekly. However, during the weeks of 08.04.2024 and 08.11.2024, there was no evidence that the chaplain completed a visit to the patient; there was also no indication of a missed visit by the chaplain on those weeks. Patient 9: The plan of care indicates the MSW will visit the patient 1 x weekly. However, during the week of 08.18.2024, there was no evidence that the MSW completed a visit to the patient; there was also no indication of a missed visit by the MSW on this week. Patient 14: The plan of care indicates the MSW will visit the patient 1 x weekly. However, during the weeks of 08.18.2024 and 09.01.2024, there was no evidence that the MSW completed a visit to the patient; there was also no indication of a missed visit by the MSW on those weeks.

Upon observation during the home visit, there was no evidence the hospice follows acceptable standards of practice to prevent the transmission of infections and communicable diseases, including standard precautions. Patient 4: During the home visit, the SN did not place a barrier between her nursing bag and the patient's furnishings, as required by the hospice's bag technique policy.

Upon patient record review, 18 of 19 (Patient #1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 19) did not have evidence in the patient record that hospice aide assignments and duties are: • Assigned to a specific patient by a registered nurse that is a member of the interdisciplinary group • Written patient care instructions for a hospice aide must be prepared by a Registered Nurse who is responsible for the supervision of a hospice aide as specified under paragraph (h) of 418.76 • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. The use of “PRN” or “per patient choice”, for any task, whether personal care or non-personal care tasks, are not acceptable Patient 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 19: The aide care plan did not specify a frequency for the tasks the aide is to perform, such as the patient's bath or shampooing the hair.