Every finding on record at Palm Springs Hospice and Palliative Care Inc.

Upon patient record review, 4 of 14 (Patient #2,3,5,8) 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 #2,3,5,8, Plan of care documents under DME oxygen concentrator, oxygen E tanks. No evidence of oxygen order on medication profile.

Upon patient record review, 4 of 14 (Patient #5,6,7,9) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient #5,6,7,9, Upon MSW initial assessment, no evidence of funeral home was identified. No care plan with funeral home planning identified with goals and interventions.

Upon client record review, 1 of 14 (Patient #2) did not have evidence that the IDG in collaboration with the attending physician reviewed, revised and documents the individualized plan as frequently as the patient's condition requires but no less frequently then every 15 calendar days. Patient #2, IDG meeting dated 11/4/25 missing signatures of MD, MSW and RN. The disciplines were actively involved with the patient therefore there was no evidence the IDG reviewed/revised the plan of care.

Upon patient record review 5 of 14 (Patient #1,3,6,9,10) 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 #1, RN supervisory visit for aide occurred on 10/24/25 then 11/8/25 which is 15 days. No evidence of aide supervisory visit completed in 14 days. Patient #3, RN supervisory visit for aide occurred on 10/13/25 then on 11/10/25. No evidence of aide supervisory visit completed in 14 days. Patient #6, RN supervisory visit for aide occurred on 10/30/25 and 11/14/25 which is 15 days. No evidence of aide supervisory visit completed in 14 days. Patient #9, RN supervisory visit for aide occurred on 10/20/25 and 11/6/25 which is 15 days. No evidence of aide supervisory visit completed in 14 days. Patient #10, RN supervisory visit for aide occurred on 10/25/25 and 11/10/25 which is 15 days. No evidence of aide supervisory visit completed in 14 days.

Upon patient client record review, 3 of 14 (Patient #2,3,9) did not have evidence that each patient record contains Advance Directives. Patient #2,3,9, Documentation on consent stating patient has POA. No evidence of copy of POA obtained and uploaded into chart.