Every finding on record at Pacific Hospice Care Corporation

Observed in Patient Home. In 3 of 3 home visits conducted, the organization did not provide the patient with written information about its policies on advance directives. In reviewing the documents in the home folder during HV#1, the surveyor found that neither the policy on advance directives nor the California advance directive requirements were provided. This was reviewed with the Administrator/DPCS.

Observed in Record Review. In the record of RR#6 the surveyor did not find a signed revocation statement as required by the Discharge from Hospice policy 5.06. Nor was there documentation of attempts by the organization to get the revocation statement signed. This was reviewed with the Administrator/DPCS.

Observed in Patient Home. During HV#1 the surveyor observed that duplicate drug therapy was not assessed for a patient with the following seven medications ordered for constipation: Senna, Colace, Glycolax, Milk of Magnesia, Lactulose, Bisacodyl, and Fleet enema. This was discussed with the Administrator/DPCS.

Observed in Record Review. In 7 of 7 patient records reviewed, the surveyor found that most interdisciplinary group meeting notes did not document decline, and progress towards desired outcomes and goals for patients receiving hospice services for one or more benefit periods. This was discussed with the Administrator/DPCS.

Observed in Record Review. In 11 of 11 patient records reviewed, it was noted that prn visits were ordered without regularly scheduled visits for the Spiritual Counselor. And the Social Worker was scheduled to visit patients only for recertification of the hospice benefit. This was discussed with the Administrator/DPCS.

Observed in Patient Home. In 1 of 3 home visits conducted, where medication reconciliation was completed, the list was inaccurate. During HV #1 the surveyor found that the patient record did not include the correct dose for Carbamazepine 200 milligrams. The medication list noted one tablet twice a day, however the label on the medication bottle read two tablets in the morning, two tablets at noon and one tablet in the evening. This was confirmed by the Administrator/DPCS.

Observed in Patient Home. In 3 of 3 home visits conducted, the surveyor found that patients and caregivers were not provided individualized emergency plans that addressed specific needs such as use of oxygen, home medical equipment, mobility issues, etc. Additionally, there was documentation in their records to indicate that education was provided. This was discussed with the Administrator/DPCS.