Every finding on record at Saint Adams Hospice

Upon patient record review, 2 of 5 (Patient 4,5) did not have evidence that the medications on the medication profile are consistent with the medications on the plan of care and what the patient/caregiver states they are taking. Patient #4 upon observation during home visit, prescription bottle for Prednisone 1mg tablet take 2 tabs orally daily and prescription bottle for Rosuvastatin 10mg tablet take one daily. Pt verified this is what she is taking. Medication profile listed: Prednisone 1mg tablet take 5 tablets every morning and Rosuvastatin 5mg tablet take one daily. Patient #5 Medication profile lists Acetaminophen 500mg capsule, 2 caps oral, three times a day for pain. Upon home visit patient reports she does not take it routinely and will take it "as needed" for pain.

Upon patient record review, 2 of 5 (Patient #4,5) 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 #4 upon observation during home visit, prescription bottle for Prednisone 1mg tablet take 2 tabs orally daily and prescription bottle for Rosuvastatin 10mg tablet take one daily. Pt verified this is what she is taking. Plan of care listed: Prednisone 1mg tablet take 5 tablets every morning and Rosuvastatin 5mg tablet take one daily. Patient #5 plan of care lists Acetaminophen 500mg capsule, 2 caps oral, three times a day for pain. Upon home visit patient reports she does not take it routinely and will take it "as needed" for pain.

Upon personnel record review, 1 of 14 (Personnel #5) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: (This standard applies to all Hospice Aides providing care/service who are directly employed by the hospice or through a contractual agreement.) ·Communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other hospice staff. ·Reading and recording temperature, pulse, and respiration ·Safe transfer techniques and ambulation. ·Normal range of motion and positioning ·Appropriate and safe techniques in personal hygiene and grooming that include-- ·(B) Sponge bath ·(C) Shampoo, bed The other subject areas in this section may be evaluated through written examination, oral examination or after observation of a Hospice Aide with a patient. Personnel #5 did not have competency completed on Shampoo in Bed, or a Sponge Bath.

Upon patient record review, 2 of 5 (Patient #1,2) did not have evidence that if a patient revokes the election of hospice care or is discharged from hospice in accordance with §418.26, the hospice must forward to the patient's attending physician: • A copy of the hospice discharge summary • The patient's clinical record, if requested Patient #1,2 Revoked their Hospice Benefit to pursue aggressive treatment. There is no evidence of the discharge summary being sent to an attending physician.