Every finding on record at Premier Hospice Central, LLC

Observed in Record Review. In 3 of 8 patient records reviewed, it was noted the organization failed to ensure that the plan of care includes all services needed for the palliation and management of the terminal illness and related conditions, including the medications and treatment necessary to meet the patient’s needs. For example, in RRHV#3, a wound care order dated 05/30/2025 for Triamcinolone cream 0.5% did not identify the specific wound location. Additionally, the patient was receiving home oxygen therapy, however, there was no corresponding physician order found in the clinical record to support this intervention. In record RRHV#2, several physician orders were found to be incomplete or lacking essential details such as: the order for home oxygen therapy did not specify the oxygen flow rate or the frequency of administration; an order dated 05/25/25 transfer and treat lacked additional context or details; a wound care order dated 07/14/25 directed the application of antibiotic ointment, but failed to specify the type of antibiotic, the location of the wound, the frequency of application, and the clinical justification for PRN use. Lastly, in RRBEV#1, an order dated 03/31/25 PRN lacked additional context or details. This finding was discussed and validated by the hospice management team.

Observed in Record Review. In 4 of 5 closed records with aide personal care services reviewed, it was noted the organization failed to ensure that the registered nurse prepares written patient care instructions for the hospice aide. For example in RRDC#2; RRDC#3, RRBEV#1 and RRBEV#2, although the Hospice Aide Care Plan instructed the aide to monitor vital signs TPR BP on every visit. However, it did not include clearly defined parameters or specific guidance on when to notify nursing supervisor of abnormal findings. This finding was discussed and validated by the hospice management team.

Observed in Patient Home. In 3 of 3 home visits conducted, it was noted the organization failed to ensure that the patient records contains a list of medications, including dose, strength, frequency, route, date and time of administration for prescription and nonprescription medications, herbal products, and home remedies that relate to the patient's care, treatment, or services. For example in record of RRHV#1, the over-the-counter medication (Visine) for eye dryness had been ongoing for an extended period but was not documented in the patient's medication profile. In record of RRHV#2, the following medications were not included in the current medication profile: Spironolactone 25 mg 1 tablet PO daily; Potassium 20 mEq 1 tablet PO daily. Additionally, the patient's current regimen Lasix 40 mg 1.5 tablets every morning was not accurately reflected in the medication profile, which listed the medication as 40 mg 1 tablet daily for only three days. The medication list had not been updated to reflect the patient's ongoing dosage. In record of RRHV#3, the Isosorbide ER 120 mg 1 tablet orally daily, had been taken consistently for approximately four months, yet it remained not included in the current medication profile. This finding was discussed and validated by the hospice management team.