Every finding on record at Precious Hospice Care, Inc

Upon patient record review, 5 of 14 (Patient #7, #8, #9, #11 and #12) 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 medication profile includes "Norco 5mg-325mg tab 1 tab orally every 4 hours as needed for severe pain" with no daily dosage limit. Patient #8 medication profile includes "Tylenol #3 with codeine orally 1 tab every 6 hours as needed for mod to severe pain" with no medication dosage and no daily dosage limit. Patient #9 medication profile includes "Loperamide Hydrochloride 2mg orally 1 tab after each episode of diarrhea" with no daily dosage limit and "Sumatriptan Succinate 100mg tab 1 tab orally, repeat in 2 hours if migraine persists" with no frequency and no daily dosage limit. Patient #11 medication profile includes "Hydrocodone/APAP 5mg-325mg tab 1 tab orally every 6 hours as needed for severe pain" with no daily dosage limit. Patient #12 medication profile includes "Norco 5mg-325mg tab 1 tab orally every 6 hours as needed for moderate pain" with no daily dosage limit.

Upon patient record review, 5 of 14 (Patient #7, #8, #9, #11 and #12) 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 #7 plan of care includes "Norco 5mg-325mg tab 1 tab orally every 4 hours as needed for severe pain" with no daily dosage limit. Patient #8 plan of care includes "Tylenol #3 with codeine orally 1 tab every 6 hours as needed for mod to severe pain" with no medication dosage and no daily dosage limit. Patient #9 plan of care includes "Loperamide Hydrochloride 2mg orally 1 tab after each episode of diarrhea" with no daily dosage limit and "Sumatriptan Succinate 100mg tab 1 tab orally, repeat in 2 hours if migraine persists" with no frequency and no daily dosage limit. Patient #11 plan of care includes "Hydrocodone/APAP 5mg-325mg tab 1 tab orally every 6 hours as needed for severe pain" with no daily dosage limit. Patient #12 plan of care includes "Norco 5mg-325mg tab 1 tab orally every 6 hours as needed for moderate pain" with no daily dosage limit.