Every finding on record at Smoky Mountain Home Health and Hospice, I N C

Based on agency policy review, medical record review and interview, the agency failed to implement a bowel regimen for 2 Patients (#9 and #6) of 19 patients reviewed for opioid medications. --- The findings include: Review of the agency policy, ";Bowel Management," undated revealed ";...the use of pain medications is usually the major cause of constipation...Untreated constipation can lead to more serious condition...impaction or bowel obstruction...and a daily bowel program can prevent such problems..." Review of the agency policy, ";Pain Management," dated 2022, revealed ";...Nursing and therapy...will follow the established plan of care..." Medical record review revealed Patient #9 was admitted to the agency on 11/6/2024 with diagnoses including Non-Hodgkin Lymphoma. Medical record review of the Hospice Plan of Care dated 11//2025, showed Patient #9 had been ordered Morphine sulfate 10mg/ml (milligrams/milliliter-an opioid used to treat pain) administer 5-10 milligrams intramuscularly every 4-6 hours as needed and oxycodone 15 mg oral tablet; take 1 tab oral 3 times a day. Medical record review of the medication profile summary showed Patient #9 had not been ordered medications for constipation. Medical record review revealed Patient #6 was admitted to the agency on 2/28/2025 with diagnoses including Alzheimers Disease. Medical record review the Hospice Plan of Care dated 2/28/2025, showed Patient #6 had been ordered acetaminophen-hydrocodone 325-5 mg (an opioid used to treat pain) oral tablet every 6 hours as needed for pain. Medical record review of the Hospice Plan of Care showed Patient #6 had not been ordered medications for constipation. During an interview on 3/12/2025 at 11:30 AM the Administrator confirmed the agency failed to implement a bowel regimen for Patients #9 and #6 who received opioids.