Every finding on record at Precise Personalized Care Hospice, LLC

Upon patient record review, 10 of 19 (Patient #1,2,3,4,5,6,8,12,13,15) 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 #1: Desitin 40% topical oint topical q 6 hrs prn denoted no site denoted no dosage denoted. Patient #2 Lantiseptic small amount top bid and prn skin integrity- no site denoted. Patient #3 Acidophilus oral capsule once a day- no dosage denoted. Lantiseptic small amount top bid and prn skin integrity- no site denoted. Miralax oral powder for reconstitution oral 1x day- no dosage denoted, no dilutent denoted. Patient #4 MOM 8% oral solution oral qd prn constipation- no dosage denoted. Patient #5 Benzapril 40 mg daily until supply ends then start lisinopril, both benzapril and lisinopril were denoted without benzapril being discontinued. Lantiseptic small amount top bid and prn skin integrity- no site denoted. Lidocaine 4% topical film apply patch and keep on for 12 hours then off for 12 hours prn pain- no site denoted. Patient #6 Hydrocortisone 1% top cream apply to back rash BID routine and prn- no dosage denoted. Patient #8 TAO not listed on medication profile for orders on POC dated 7/5/23: Cleanse with w/c or N/S, pat dry, apply TAO, cover with Border gauze 2xwk. Patient #12 Lantiseptic top oint 3xday and prn skin- no dosage denoted, no site denoted. Miralax oral powder for reconstitution oral 1x day- no dosage denoted, no diluent denoted. Zinc oxide 10% top oint 3xday and prn skin integrity- no site denoted, no amount denoted. Patient #13 Miralax oral powder for reconstitution 17 gm oral 1x day- no dilutent denoted. Patient #15 Miralax oral powder for reconstitution 17 gm oral 1x day- no dilutent denoted.

Upon patient record review, 9 of 19 (Patient #1,2,3,4,5,6,12,13,15) 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: Desitin 40% topical oint topical q 6 hrs prn denoted no site denoted no dosage denoted Patient #2 Lantiseptic small amount top bid and prn skin integrity- no site denoted Patient #3Acidophilus oral capsule once a day- no dosage denoted. Lantiseptic small amount top bid and prn skin integrity- no site denoted. Miralax oral powder for reconstitution oral 1x day- no dosage denoted, no dilutent denoted. Patient #4 MOM 8%oral solution oral qd prn constipation- no dosage denoted Patient #5 Benzapril 40 mg daily until supply ends then start lisinopril, both benzapril and lisinopril were denoted without benzapril being discontinued. Lantiseptic small amount top bid and prn skin integrity- no site denoted. Lidocaine 4% topical film apply patch and keep on for 12 hours then off for 12 hours prn pain- no site denoted. Patient #6 Hydrocortisone 1% top cream apply to back rash BID routine and prn- no dosage denoted Patient #12 Lantiseptic top oint 3xday and prn skin- no dosage denoted, no site denoted. Miralax oral powder for reconstitution oral 1x day- no dosage denoted, no dilutent denoted. Zinc oxide 10% top oint 3xday and prn skin integrity- no site denoted, no amount denoted. Patient #13 Miralax oral powder for reconstitution 17 gm oral 1x day- no dilutent denoted Patient #15 Miralax oral powder for reconstitution 17 gm oral 1x day- no dilutent denoted

Upon patient record review 3 of 19 (Patient #15,17,19) 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 #15: Aide care plan dated 5/9/23 assigns shower 2xwk and bath partial 3xwk. Both shower and bath partial are documented 6/5, 6/8, 6/9/23 which is greater than frequency assigned. Patient #17 Aide care plan dated 5/19/23 assigns nail trim weekly. Nail trim is documented on 5/22/23, 5/25, 5/29, 6/1, 6/5, 6/8, 6/12 and 6/15 which is greater than frequency assigned. Patient #19 Aide care plan dated 5/9/23 assigned shave 1xwk and bath 2xwk. Both were documented 6/26-6/30/23 which is greater than frequency assigned.