Ahc Home Health of Kansas, LLC (Hospice)

“Upon patient record review, 5 of 19 (Patient #8,11,14,17,19) 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 #8 - Medication profile contained Nystatin 100,00 topical powder - apply 1 application every 8 hours as needed for yeast - did not contain site. Patient #11 - Medication profile contained Epoetin alfa 20,000 u/ml inject 3,000 units IV once a week. Order does not contain ml to give and mediation is being given subcutaneous and not IV. Patient #14 - Medication profile contained Triamcinolone 0.1% apply 1application every 24 hours as needed for rash - did not contain site. Patient #17 - Medication profile contained Mupirocin 2% apply 1application topically 2 times a day - did not contain site. Patient #19 - Medication profile contained Gentamicin 40 mg/ml; Inject 40mg/ml 3 times a week - Inject via catheter three times a week - Order on bottle reads: Gentamicin 160mg/500 ml Inject 60ml via catheter three times a week.”

“Upon patient record review, 3 of 19 (Patient #11,15,19) 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 #11 - Plan of care contained Epoetin alfa 20,000 u/ml inject 3,000 units IV once a week. Order does not contain ml to give and medication is being given subcutaneous and not IV. Patient #15 - Plan of care contains “skin care teaching to open blister on feet and legs apply Zinc or Antibiotic ointment, cover with ABD and Kerlix or bordered dressing until healed” does not contain what to clean wound with or frequency of wound care. Wound care should be specific as to what topical should be used and type of cover dressing. Patient #19 - Order for Gentamicin 40 mg/ml; Inject 40mg/ml 3 times a week - Inject via catheter three times a week - Order on bottle reads: Gentamicin 160mg/500 ml Inject 60ml via catheter three times a week. Contained change Foley Catheter #14F 1 x month and PRN for leakage or dislodged - did not contain balloon size or that it was a Coude’ Foley Catheter.”

“Upon home visit observation on 1 of 4 visits, there was no evidence the hospice follows acceptable standards of practice to prevent the transmission of infections and communicable diseases, including standard precautions. Patient #4 - Upon observation of hospice nurse the following was observed: SN put bag on floor without a barrier, washed hands in bathroom using patient’s soap and drying hands with patient’s cloth towel. Nurse went back into bag several times without using hand sanitizer. When nurse arrived patient had bag lying on floor next to his chair and did not educate patient that bag should not be kept below the waist and should not be placed on the floor. Per agency Bag Technique Policy No. 66-013.1 - Clinician should carry own soap and paper towels and alcohol based hand rub for washing hands. Bag should be placed on a clean surface or barrier. Before entering the bag hands should be decontaminated prior to returning to bag.”

“Upon patient record review 2 of 19 (Patient #8, 9) 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 Aide missed visit Patient #8 - Aide visit frequency 2wk 12, only 1 visit made week 1 without documentation of missed visit. Patient #9 - Aide visit frequency 2wk 12, only 1 visit made week 1 without documentation of missed visit.”

“Upon patient record review 2 of 19 (Patient #8,15) did not have evidence documentation in the patient record that a Registered Nurse made an on-site visit to the patient’s home no less frequently than every 14 days to assess the quality of care and services provided by the hospice aide and to ensure that services ordered by the hospice interdisciplinary group meet the patient’s needs. Patient #8 - The record indicated that an aide supervisory visit was conducted on 4/16/26 and no other supervisory visit as of 5/19/26. Patient #15 - The record indicated the aide first visit was 4/23/26 aide supervisory visit was conducted on 5/8/26 - one day late.”

“Upon patient client record review, 2 of 19 (Patient #11, 17) 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 #11 - SN documented on visit 04/27/26 “wound care performed without complaints” and 05/13/26 - “wound care performed per care plan”. Patient #17 - SN documented on visit 05/12/26 and 05/12/26 - “wound care right leg performed per care plan”.”