Gentiva I

“Upon patient record review, 4 of 19 (Patients #1,#7,#10,#13) did not have evidence in the patient record that a review was completed of all prescription and non-prescription medications. Patient 1: During home visit medication reconciliation the facility and hospice medication profiles did not match. The facility profile did not contain instructions for a bisacodyl suppository that was on the hospice profile. Patient 7: During home visit medication reconciliation the facility and hospice medication profiles did not match. The facility profile contained Zyrtec that was not on the hospice profile, Flonase as a PRN instead of scheduled, and the facility did not have iron scheduled that was on the hospice profile. Patient 10: During home visit medication reconciliation the facility and hospice medication profiles did not match. The facility profile did not contain morphine PRN that was on the hospice profile, contained pantoprazole dose of 20mg compared to hospice 40mg, and sertraline dose of 25mg compared to hospice 50mg. Patient 13: During home visit medication reconciliation the facility and hospice medication profiles did not match. The facility profile contained guaifenesin and loratadine that was not on the hospice profile, did not have acetaminophen, Aleve, and Dulcolax that were on the hospice profile, contained a Seroquel dose of 25mg compared to hospice 50mg, contained melatonin 10mg compared to hospice 3mg and trazadone 75mg instead of hospice 50mg.”

“Upon patient record review, 3 of 19 (Patients #7,#10,#13) 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 7: During home visit medication reconciliation the facility and hospice medication orders did not match. The facility had an order for Zyrtec that was not on the hospice record, an order for Flonase as a PRN instead of scheduled, and the facility did not have an order for iron scheduled that was on the hospice record. Patient 10: During home visit medication reconciliation the facility and hospice medication orders did not match. The facility contained an order for pantoprazole dose of 20mg compared to hospice order for 40mg, and an order for sertraline dose of 25mg compared to hospice 50mg. Patient 13: During home visit medication reconciliation the facility and hospice medication orders did not match. The facility record contained orders for guaifenesin and loratadine that was not on the hospice record, facility did not have orders for acetaminophen, Aleve, and Dulcolax that were on the hospice record, contained an order for Seroquel dose of 25mg compared to hospice 50mg, contained melatonin 10mg compared to hospice 3mg and trazadone 75mg instead of hospice 50mg.”

“Upon patient record review, 5 of 19 (Patients #1,#2,#5,#8,#13) 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 1: The medical record contained nursing documentation upon recertification assessment 6/30/26 identifying patient use of a mattress overlay. There was no evidence of an order for the DME included in the plan of care. Patient 2: The medical record contained nursing documentation upon recertification assessment 7/6/26 identifying patient use of a low air loss mattress; however, not on POC. After leadership investigation, the patient does not have the mattress. Patient 5: The medical record contained nursing documentation upon recertification assessment 4/22/26 identifying patient use of a mattress overlay. There was no evidence of an order for the DME included in the plan of care. Patient 8: The medical record contained nursing documentation upon recertification assessment 5/4/26 and during visit 6/19/26 identifying patient use of a walker. There was no evidence of an order for the DME included in the plan of care. Patient 13: The medical record contained nursing documentation upon recertification assessment 7/14/26 identifying patient use of a hospital bed and overbed table. There was no evidence of orders for the DME included in the plan of care.”

“Upon patient record review, 2 of 19 (Patients #3,#9) did not have evidence in the patient record that hospice aide assignments and duties are specific to the patient’s needs. Patient 3: The aide care plan contained instructions to apply barrier ointment to coccyx after bath and incontinence cares. There was no evidence the aide care plan was updated when wound care advance to requiring dressings. Patient 9: The aide care plan contained instructions for an indwelling catheter. There was no evidence the aide care plan was updated when the catheter was discontinued on 7/8/26.”

“Upon patient client record review, 1 of 19 (Patients #19) 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 19: The medical record contained a discharge summary inaccurately identifying that the patient was a revocation. After agency investigation, the patient was confirmed as admitted to a hospital that was not within the agency’s ability to provide service.”