Gentiva

“Upon patient record review, 2 of 19 (Patients #5, #13) 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 #5: The medication profile contained duplicate Keppra entries with differing doses and differing administration routes of oral and PEG tube. The medication profile also contained an order for MiraLax, however there were no mixing instructions for this medication. The medication profile also contained an order for Famotidine tablets to administer via PEG tube, however there were no instructions how to prepare medication for PEG tube administration. Corrected on site with order clarification and medication profile updated. Patient #13: During medication reconciliation, the facility and hospice medications did not match. The facility medication profile contained acetaminophen with administration route as suppository. The hospice medication profile contained acetaminophen with administration route as oral. The hospice medication profile also contained PRN orders for guaifenesin and Milk of Mag, but these medications were absent from facility medication profile.”

“Upon patient record review, 2 of 19 (Patient #2, #5) 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: The medical record indicated patient has a skin tear to left lower arm with foam border dressing in place. There is no evidence of a wound care order. Patient #5: There were duplicate Keppra orders with differing doses and differing administration routes of oral and PEG tube. The order for MiraLax did not have mixing instructions for this medication. The order for Famotidine tablets to administer via PEG tube, however there were no instructions to prepare medication for PEG tube administration. Corrected on site with order clarification and medication profile updated.”

“Upon patient record review, 4 of 19 (Patient #3, #5, #6, #11) 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: The medical record contained nursing documentation upon admission identifying patient use of gel mattress. There was no evidence of orders for the DME included in the plan of care. Corrected on site with orders received. Patient 5: The medical record contained DME order for O2. There was no evidence of need or physician order for O2. Corrected on site with DME order discontinued. Patient 6: The medical record contained nursing documentation upon admission identifying patient use of bed rails. There was no evidence of orders for the DME included in the plan of care. Corrected on site with orders received. Patient 11: The medical record contained DME order for O2. There was no evidence of need or physician order for O2. Corrected on site with DME order discontinued.”

“Upon patient record review 3 of 19 (Patient #6, #8, #12) 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 Patient 6: The medical record contained an order for aide visits three times weekly. There was no evidence of third visit made weeks of 10/12/25 and10/19/25. Patient 8: The medical record contained an order for aide visits three times weekly. There was only one visit made week of 10/5/25. Patient 12: The medical record contained an order for aide visits two times weekly. There was no evidence of second visit made week of 11/23/25.”

“Upon client record review, 2 of 19 (Patient #5, #13) did not have evidence that a written hospice plan of care is established and maintained in consultation with SNF/NF or ICF/IID representatives. All hospice care provided is in accordance with this hospice plan of care. Patient 5: There was an order for nurse visit frequency of twice weekly. There was no evidence of second visit made weeks of 11/9/25 and 11/16/25. Patient 13: There was an order for chaplain visit frequency of three visits a month. There was no evidence of third visit made in October.”

“Upon client record review, 1 of 19 (Patient #5) did not have evidence that the hospice plan of care identifies the care and services that are needed and specifically identify which provider (nursing facility or hospice) is responsible for performing the respective functions that have been agreed upon and included in the hospice plan of care. Patient 5: The record indicates the patient has a PEG tube, however the care plan did not indicate who was responsible for the care of the Peg tube. Corrected on site with orders received and care plan updated.”