Deficiency Index

Every finding on record at Tdx5 LLC

Star, Idaho · CCN 131588

3 findings across 1 survey, in the inspector's own words.

The inspector’s own words from form CMS-2567, unedited, including CMS’s own spacing. Names and some dates are redacted by CMS.

Survey of July 27, 2023

3 findings
L0549

Upon patient record review, 1 of 11 (Patient #4) 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 - POC dated 05/01/2023 contained "clean wound with wound cleanser, Pack with soaked gauze, absorbent pad, tape securely QOD or as needed without indicating what cleanser to use, what the gauze should be soaked in and without a modifier for as needed. Corrected on site.

L0555

Upon client record review, 1 of 11 (Patient #4) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient #4 - POC dated 05/01/2023 SN visit frequency 2x month - SN made visit 2wk1, 1wk6. Corrected on site for past visits and new visit frequency effective 06/18/2023.

L0626

Upon patient record review 1 of 11 (Patient #2) did not have evidence documentation in the patient record that a hospice aide provides services that are: • Ordered by the interdisciplinary group • Included in the plan of care • Permitted to be performed under state law by such hospice aide • Consistent with the hospice aide training Patient #2 - Aide POC included task shave 1 x wk - Aide visiting 2 x wk and shaved both visit week of 05/23/2023, 05/28/2023 and week of 07/23/2023

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Federal survey findings only. State licensure findings for hospices are not shown.

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