Every finding on record at Park Point Healthcare LLC

Upon patient record review, 3 of 14 (Patient #2,3,8) 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: Current medication profile includes orders for Nystop 100,000 Unit/gram topical powder. Ordered dose is per instruction, the instruction dose not include an amount to apply Patient #3: Current medication profile includes orders for Voltaren 1% gel. Ordered dose is per instruction. Instruction does not include an amount of application. Current Medication Record includes orders for Nystatin 100,000 unit/gram topical powder. Ordered dose is per instruction, the instruction does not include an amount of application. Medication Record includes orders for Biofreeze 1% topical cream. Ordered dose is per instruction, instruction does not include an amount of application. Patient #8: Current medication profile contains orders for Acetaminophen 500mg (2) tabs twice daily for pain and Acetaminophen 500mg (2) tabs every 6-8 hours as needed for pain. There is no directive not to exceed 4g daily. Current Medication Record includes orders for Calmoseptine 0.44% topical ointment. Ordered dose is per instruction and frequency as needed, order does not include frequency or site of application.

Upon patient record review, 1 of 14 (Patient #8) did not have evidence in the patient record that the comprehensive assessment includes a bereavement component which includes the needs of the patient's family and other individuals focusing on the social, spiritual, and cultural factors that may impact their ability to cope with the patient's death. Information gathered from the initial bereavement assessment is incorporated into the plan of care and is considered in the bereavement plan of care. Patient #8: Patient was admitted on 04/20/24. There is no evidence the initial comprehensive bereavement assessment was completed until 08/29/24.

Upon patient record review, 1 of 14 (Patient #1) 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 #1: Patient is receiving continuous tube feedings via PEG tube. The current POC does not show evidence of interventions to manage and monitor safe enteral tube feedings.

Upon patient record review, 4 of 14 (Patient #1,2,3,8) 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 #1: Patient is receiving continuous tube feeding via PEG tube. Agency policy states "Enteral tube feeding, continuous, gastrostomy and jejunostomy", includes implementation of placement checks, enteral tube water flush or residual checks. The POC does not include orders. Patient #2: Current Medication Record includes orders for Nystop 100,000 Unit/gram topical powder. Ordered dose is per instruction, the instruction dose not include an amount to apply Patient #3: Current POC includes orders for Voltaren 1% gel. Ordered dose is per instruction. Instruction does not include an amount of application. Current POC includes orders for Nystatin 100,000 unit/gram topical powder. Ordered dose is per instruction, the instruction does not include an amount of application. POC includes orders for Biofreeze 1% topical cream. Ordered dose is per instruction,instruction does not include an amount of application. Patient #8: Current POC contains orders for Acetaminophen 500mg (2) tabs twice daily for pain and Acetaminophen 500mg (2) tabs every 6-8 hours as needed for pain. There is no directive not to exceed 4g daily. Current Medication Record includes orders for Calmoseptine 0.44% topical ointment. Ordered dose is per instruction and frequency as needed, order does not include frequency or site of application.

Upon patient record review, 2 of 8 (Patient #3,#6) 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 3: Polyethylene Glycol 3350 17grams powder packet 1 packet orally every other day for constipation. No evidence that a diluent was listed on MAR. Prochlorperazine Maleate 10mg 1 tab PRN for nausea. Frequency listed as "O2 PRN". No evidence that correct frequency was listed on MAR. Both corrected on site. Patient 6: Polyethylene Glycol 3350 17grams powder packet 1 packet orally PRN daily for constipation. No evidence that a diluent was listed on MAR.

Upon patient record review, 2 of 8 (Patient #3,#6) 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 3: Polyethylene Glycol 3350 17grams powder packet 1 packet orally every other day for constipation. No evidence that a diluent or instructions on how to dilute the powder was listed on order. Prochlorperazine Maleate 10mg 1 tab PRN for nausea. Frequency listed as "O2 PRN". No evidence that correct frequency was listed on order. Both corrected on site. Patient 6: Polyethylene Glycol 3350 17grams powder packet 1 packet oral PRN daily for constipation. No evidence that a diluent or instructions on how to dilute the powder was listed on the order.