Every finding on record at Reverent Hospice Care Inc.

Upon patient record review, 1 of 6 (Patient #1) 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 During the home visit patient stated that patient takes Kombiglyze but has been out for 4 days and the medication was not in the plan of care.

Upon patient record review, 1 of 6 (Patient #1) 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 During the home visit patient stated that patient takes Kombiglyze but has been out for 4 days and there was no order on file in agency records.

Upon patient client record review, 6 of 6 (Patient #1, #2, #3, #4, #5, #6) did not have evidence that each patient record contains: • Signed copies of the notice of patient rights in accordance with 418.52 • Signed election statement in accordance with 418.24 Patient #1, #2, #3, #4, #5, #6 Election of Benefit does not provide BFCC-QIO name or phone number.