Every finding on record at Tender Loving Hospice Care, Inc.

Upon patient record review, 3 of 14 (Patient 2, 8 & 10) 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 2 medication profile included “Creon 120,000 units orally, 24000 units three to four times daily” with unclear frequency. Patient 8 medication profile included “A&D ointment topically apply to all high-pressure areas daily as needed for redness/irritation” with location unclear. “Ca-rezz cream topically apply to all high-pressure areas daily as needed for redness/irritation” with location unclear. Patient 10 medication profile included “Ca-rezz cream topically apply to all high pressure areas daily as needed for redness/irritation” with location unclear. “Loperamide Hydrochloride 2mg oral tab, take 2 tabs after the first loose stool, then 1 tab after each loose stool daily as needed for diarrhea” with no daily dosage limit indicated.

Upon patient record review, 3 of 14 (Patient 2, 8 &10) 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 2 plan of care included “Creon 120,000 units orally, 24000 units three to four times daily” with unclear frequency. Patient 8 plan of care included “A&D ointment topically apply to all high-pressure areas daily as needed for redness/irritation” with location unclear. “Ca-rezz cream topically apply to all high-pressure areas daily as needed for redness/irritation” with location unclear. Patient 10 plan of care included “Ca-rezz cream topically apply to all high pressure areas daily as needed for redness/irritation” with location unclear. “Loperamide Hydrochloride 2mg oral tab, take 2 tabs after the first loose stool, then 1 tab after each loose stool daily as needed for diarrhea” with no daily dosage limit indicated.

Upon client record review, 3 of 14 (Patient 5, 10 & 12) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient 5 plan of care notes “LVN/SN visits once weekly”. No evidence of SN visit week of 9/3-9/9/23 and no missed visit communication. Patient 10 MD order dated 6/8/23 “SN to perform wound care 3 x weekly”. Frequency unmet for weeks of: 6/11-6/17: SN x 2 visits made and no missed visit communication. 6/25-7/1: SN x 2 visits made and no missed visit communication. 7/2-7/8: SN x 2 visits made and no missed visit communication. 7/9-7/15: SN x 1 visit made and no missed visit communication. Patient 12 plan of care notes "SN visits 1 x weekly" No evidence of SN visit 7/9-7/15 and no evidence of missed visit notes. No evidence of SN visit 7/23-7/29 and no evidence of missed visit notes.