Every finding on record at Safe Hands Hospice Care Inc

Upon patient record review, 1 of 5 (Patient 3) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient 3: Medication profile and physician orders include "Clopidogrel 75mg take 1 tablet daily by mouth". The written plan of care did not address this high risk medication with a problem identification, goals and interventions to ensure bleeding precautions were implemented for patient safety.