Choice Hospice

“Upon patient record review, 3 of 19 (Patient #2,4,6) 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: On the medication profile there is an order for Latanoprost 0.005% eye drops and Timolol 0.5% eye drops, 1 drop, there are not instructions for one eye or both eyes. There is an order for Polyethylene Glycol 17g, there is no diluent. Corrected on site. Patient 4: On the medication profile there is an order MiraLAX 17g, there is no diluent. Corrected on site. Patient 6: There are medications on the facility medication profile that are not on the hospice medication profile/plan of care; Volteren External gel 1% 2 grams every eight hours. On the hospice medication profile there is an order for Morphine concentrate 10mg/ml 0.25ml every 4 hours as needed and is not on the facility medication profile. Corrected on site.”

“Upon patient record review, 3 of 19 (Patient #2,4,7) 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: On the patient plan of care there is an order for Latanoprost 0.005% eye drops and Timolol 0.5% eye drops, 1 drop, there are not instructions for one eye or both eyes. Corrected on site. Patient 4: On the recent plan of care there is an order for MiraLAX 17g, there is no diluent ordered. Corrected on site. Patient 7: There is evidence in the RN assessment that the patient has a foley catheter, there is not an order for the care of the foley.”

“Upon patient record review, 8 of 19 (Patient #3,4,7,8,10,11,12,14) 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 equipment and supply needs. Patient 3: On 10/7/25 the RN documented that there is oxygen in the home and the patient is on continuous oxygen. There is not an order for DME oxygen concentrator on the plan of care. Corrected on site. Patient 4: On 8/12/25 the RN documented that the Pt. has a walker/wheelchair, there is not an order for DME walker/wheelchair on the plan of care. Corrected on site. Patient 7: There is no DME listed on the recent plan of care, there is documentation in the patient record that the patient has a wheelchair. Corrected on site. Patient 8: There is no DME listed on the recent plan of care, however there is documentation in the SN assessment that the patient has a wheelchair. Corrected on site. Patient 10: On the plan of care there is an order for Albuterol for nebulization, there is not a nebulizer machine listed for DME on the plan of care. Corrected on site. Patient 11: In the RN assessment there is documentation that the patient has a wheelchair, there is not a DME order, walker on the plan of care. Corrected on site. Patient 12: On the RN comprehensive assessment the SN documents activity up as tolerated with walker, there is not a walker listed on for DME on the plan of care. Corrected on site. Patient 14: On the RN comprehensive assessment there is documentation that the patient is oxygen dependent, has a Hoyer lift and wheelchair, there is not a DME order with these items on the plan of care. Corrected on site.”

“Upon patient record review, 2 of 19 (Patient #7,11) did not have evidence in the patient record that hospice aide assignments and duties are: • Assigned to a specific patient by a registered nurse that is a member of the interdisciplinary group • Written patient care instructions for a hospice aide must be prepared by a Registered Nurse who is responsible for the supervision of a hospice aide as specified under paragraph (h) of 418.76 • There is evidence in the patient record that the plan of care; indicate what tasks are to be done by the Aide and the frequency of these tasks. The use of “PRN” or “per patient choice”, for any task, whether personal care or non-personal care tasks, are not acceptable Patient 7: On the aide plan of care there is an order to transfer client from bed to chair every visit as needed, the frequency cannot be as needed. Corrected on site. Patient 11: On the aide plan of care there is an order to shave every visit as needed, the frequency cannot be as needed. Corrected on site.”

“Upon patient client record review, 3 of 19 (Patient #1,2,13) did not have evidence that all entries are legible, clear, complete, and appropriately authenticated and dated in accordance with the organizations policies and procedures and currently accepted standards of practice. Electronic signatures are acceptable as long the hospice is following appropriate safeguards to prevent unauthorized access to the patient records. Patient 1: In the patient record the MSW documented, “Pt AXOX2”, AXOX2 is not an approved abbreviation. Patient 2: On 9/22/25 the SN documented “VSS and O2SAT improved”, VSS is not an approved abbreviation. On 9/22/25 the SN documented, “ENC Pt/fam to drink water”, ENC and Fam are not approved abbreviations. Patient 13: In the patient record the chaplain documented, “SCC providing active compassionate listening”, SCC is not an approved abbreviation. Chaplain documented in the patient record, “Pt. BKGD is Muslim and pt’s son is able to contact mosque if needed”. SCC is not an approved abbreviation.”