Every finding on record at Vital Hospice Care LLC

Upon patient record review, 6 of 14 (Patient 2, 4, 5, 9, 10 & 14) 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 includes "Acetaminophen oral tab 500 mg 1 tab every 4 hours prn pain/fever and Acetaminophen rectal suppository 650 mg 1 supp every 4 hours prn temp > 99.0" with no daily dosage limit. Patient 4 medication profile includes "Norco oral tab 5-325 mg tab 0.5-1 tab by mouth every 4 hours prn pain and Acetaminophen rectal suppository 650 mg 1 supp every 4 hours prn fever >99.9" with no daily dosage limit. Patient 5 medication profile includes "Norco oral tab 10-325 mg tab 1 tab every 4-6 hours prn pain and Acetaminophen rectal suppository 650 mg 1 supp every 4 hours prn fever >99.9" with no daily dosage limit. Patient 9 medication profile includes "Acetaminophen 500 mg tab 1 tab orally every 6 hours prn pain and Acetaminophen rectal suppository 650 mg 1 supp every 4 hours prn fever >99.9" with no daily dosage limit. Patient 10 & 14 medication profile includes "Acetaminophen rectal suppository 650 mg 1 supp every 4 hours prn fever >99.9" with no daily dosage limit. During survey, Agency contacted MD and obtained orders to include daily dosage limits.

Upon patient record review, 6 of 14 (Patient 2, 4, 5, 9, 10 & 14) 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 includes "Acetaminophen oral tab 500 mg 1 tab every 4 hours prn pain/fever and Acetaminophen rectal suppository 650 mg 1 supp every 4 hours prn temp > 99.0" with no daily dosage limit. Patient 4 plan of care includes "Norco oral tab 5-325 mg tab 0.5-1 tab by mouth every 4 hours prn pain and Acetaminophen rectal suppository 650 mg 1 supp every 4 hours prn fever >99.9" with no daily dosage limit. Patient 5 plan of care includes "Norco oral tab 10-325 mg tab 1 tab every 4-6 hours prn pain and Acetaminophen rectal suppository 650 mg 1 supp every 4 hours prn fever >99.9" with no daily dosage limit. Patient 9 plan of care includes "Acetaminophen 500 mg tab 1 tab orally every 6 hours prn pain and Acetaminophen rectal suppository 650 mg 1 supp every 4 hours prn fever >99.9" with no daily dosage limit. Patient 10 & 14 plan of care includes "Acetaminophen rectal suppository 650 mg 1 supp every 4 hours prn fever >99.9" with no daily dosage limit. During survey, Agency contacted MD and obtained orders to include daily dosage limits.