Every finding on record at Rize Hospice

Upon patient record review, 4 of 15 (Patient #1,3,6,8) 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 #1,8: There is evidence in the medical record the patient has an order for oxygen but oxygen does not appear on the list of medications. Patient #3: There is evidence in the medical record the patient has an order for an oxygen concentrator but oxygen does not appear on the list of medications. Patient #6: There is evidence in the medical record the patient has an order for an oxygen concentrator but oxygen does not appear on the list of medications.

Upon patient record review, 3 of 15 (Patient #1,3,6) 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: There is evidence in the medical record of an order for wound care, "Cleanse stage 2 right buttocks with NS, pat dry, apply calmoseptine and cover with foam dressing. Change in 3 days and if soiled or loose." The order does not say who will change the dressing. Patient #3: There is evidence in the medical record the patient has an order for an oxygen concentrator but there is not an order for Oxygen. Patient #6: There is evidence in the medical record the patient has an order for an oxygen concentrator but there is not an order for Oxygen.

Upon observation, there was no evidence the hospice is primarily engaged in providing the following care and services: • Nursing services • Medical social services • Physician services • Counseling services, including spiritual counseling, dietary counseling and bereavement counseling • Hospice aide, volunteer, homemaker services • Physical therapy, occupational therapy, speech-language pathology services • Medical supplies (including drugs and biologicals) and medical appliance At the start of survey, the agency did not have short term inpatient contract. A contract was obtained on day 2 of survey.

Upon patient client record review, 2 of 15 (Patient #1, #2) 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: There is evidence in the medical record the election statement did not have a completed effective date.

Upon personnel record review, 3 of 10 (Personnel #8,9,10) did not have evidence the hospice obtained a criminal background check on all contracted individuals who have direct patient care and access to patient records.