Every finding on record at Perennial Hospice, Inc

Upon patient record review, 1 of 14 (Patient #7) 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 7: There was no evidence that the patient's allergies were reviewed at the time of admission, or have been reviewed at any subsequent time. (corrected onsite)

Upon patient record review, 3 of 14 (Patient #2, 5, 8) did not have evidence the plan of care must includes all services necessary for the palliation and management of the terminal illness and related conditions, including the following: • A detailed statement of the scope and frequency of services necessary to meet the specific patient and family needs • The IDG demonstrates a proactive approach in developing each patient's plan of care by planning ahead for anticipated patient changes and needs. Decisions should reflect the patient/family preferences rather than be solely a response to a crisis. Patients 2, 5, 8: The plan of care indicated that no routine chaplain visits were scheduled but the chaplain would remain available on request. The SC comprehensive initial assessment similarly indicated that the chaplain would be available to the patient as needed. (corrected onsite)

Upon patient record review, 1 of 14 (Patient #4) 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 4: The patient had DuoNebs ordered; however no nebulizer was present on the plan of care for use. (corrected onsite)

Upon patient record review, 1 of 14 (Patient #9) did not have evidence that a revised plan of care includes information from the patient's updated comprehensive assessment and must note the patient's progress towards outcome/goals from the plan of care. Patient 9: Per the recertification comprehensive nursing assessment, the patient has compromised swallowing status. She requires a mechanical soft diet and thickened liquids; additionally, the patient's bed must be elevated to 90 degrees for half an hour after eating for safety. Finally diet treatment orders on the plan of care are entered for the mechanical soft diet with thickened liquids. However, no care plan was initiated relating to aspiration risk or swallow status. (corrected onsite)

Upon patient record review 1 of 14 (Patient #1) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient 1: HA visits were ordered for 1 x weekly. However, during the week of 06.02.2024 there was no evidence of a HA visit being completed.

Upon patient record review, 1 of 14 (Patient #6) did not have evidence that before the recertification period for each patient, the medical director or physician designee must review the patient's clinical information and provide written documentation that it is anticipated that the patient's life expectancy is 6 months or less. Patient 6: There was no evidence that the physician reviewed the patient record and provided a written statement related to patient recertification and anticipation of life expectancy.