Gentiva I

“Upon patient record review, 4 of 19 (Patient #4, #6, #7, #8) 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 4: The medication profile contained active instructions to administer Doxycycline effective 11/13/25 after agency investigation the course of antibiotics was completed but not removed from medication profile. Corrected. Patient 6: The medication profile contained an order for Atropine with inappropriate administration route of eye for excess secretions. Corrected Patient 7: During medication reconciliation, the facility and hospice medications did not match. The facility medication profile contained order for Lorazepam 0.25ML (0.5MG) to be administered every 4 hours as needed. However, the hospice medication profile contained order for Lorazepam 0.5ML to be administered every 4 hours as needed. The facility medication profile contained order for Lorazepam 0.25ML (0.5MG) to be administered at bedtime. However, the hospice medication profile contained order for Lorazepam 1MG to be administered at bedtime. The facility medication profile contained order for Metoprolol Tartrate 50mg to be administered twice daily. However, the hospice medication profile contained order for Metoprolol Succinate ER 50mg to be administered once daily. The facility medication profile contained order for Mirtazapine 15mg to be administered at bedtime. However, the hospice medication profile contained order for Mirtazapine 7.5mg to be administered at bedtime. Patient 8: The medication profile contained an order for aspercream with no administration location identified. Corrected with order clarification.”

“Upon patient record review, 1 of 19 (Patient #12) did not have evidence in the patient record that the comprehensive assessment includes a bereavement component which includes the needs of the patient’s family and other individuals focusing on the social, spiritual, and cultural factors that may impact their ability to cope with the patient’s death. Information gathered from the initial bereavement assessment is incorporated into the plan of care and is considered in the bereavement plan of care. Patient 12: The initial bereavement assessment was completed on 10/2/25 with start of care 9/25/25.”

“Upon patient record review, 3 of 19 (Patient #6, #7, #8) 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 6: The medication profile contained an order for Atropine with inappropriate administration route of eye for excess secretions. Corrected onsite with updated physician’s order. Also, on 10.24.25 RN documented UA was ordered but no evidence of order. Patient 7: During medication reconciliation, the facility and hospice medications did not match. The facility medication profile contained order for Lorazepam 0.25ML (0.5MG) to be administered every 4 hours as needed. However, the hospice medication profile contained order for Lorazepam 0.5ML to be administered every 4 hours as needed. The facility medication profile contained order for Lorazepam 0.25ML (0.5MG) to be administered at bedtime. However, the hospice medication profile contained order for Lorazepam 1MG to be administered at bedtime. The facility medication profile contained order for Metoprolol Tartrate 50mg to be administered twice daily. However, the hospice medication profile contained order for Metoprolol Succinate ER 50mg to be administered once daily. The facility medication profile contained order for Mirtazapine 15mg to be administered at bedtime. However, the hospice medication profile contained order for Mirtazapine 7.5mg to be administered at bedtime. Patient 8: The medication profile contained an order for aspercream with no administration location identified. Corrected with order clarification.”

“Upon patient record review, 2 of 19 (Patient #2, #6) 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 2: Nursing documentation upon admission identified patient use of raised toilet seat and shower chair. There was no evidence of orders for the DME included in the plan of care. Corrected onsite with order. Patient 6: Nursing documentation identified patient use of hospital bed and over the bed table. There was no evidence of orders for the DME included in the plan of care. Corrected onsite with order.”

“Upon personnel record review, 1 of 14 (Personnel #6) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: (This standard applies to all Hospice Aides providing care/service who are directly employed by the hospice or through a contractual agreement.) ·Communication skills, including the ability to read, write, and verbally report clinical information to patients, caregivers, and other hospice staff. ·Reading and recording temperature, pulse, and respiration ·Safe transfer techniques and ambulation. ·Normal range of motion and positioning ·Appropriate and safe techniques in personal hygiene and grooming that include-- ·(A) Bed bath ·(B) Sponge, tub, and shower bath ·(C) Shampoo, sink, tub, and bed ·(D) Nail and skin care ·(E) Oral hygiene ·(F) Toileting and elimination The other subject areas in this section may be evaluated through written examination, oral examination or after observation of a Hospice Aide with a patient. Personnel 6: Upon review of personnel file, there was no evidence of competency assessment on obtaining temperature, pulse and respirations.”

“Upon patient record review, 3 of 19 (Patient #1, #3, #6) 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 1: Order for aide visit frequency of one time a week, however the aide care plan indicates aide to provide a shower and shampoo on the second visit weekly. Corrected on site with updated aide care plan. Patient 3: RN documentation that aide feeds patient, however there is no task to feed patient on aide care plan. Corrected on site by updating aide care plan. Patient 6: Order for aide visit frequency of twice weekly, however the aide care plan indicates aide to provide a shower on the second and third visit weekly. Corrected with updated aide care plan.”

“Upon patient client record review, 2 of 19 (Patient #6, #13) did not have evidence that each patient record contains: • Signed copies of the notice of patient rights in accordance with 418.52 • Signed election statement in accordance with 418.24 Patient 6: The election form identified the patient elected to receive the Notification of Hospice Non-Covered items upon admission 6/18/24 but was not furnished until 7/2/25. Patient 13: The election form identified the patient elected to receive the Notification of Hospice Non-Covered items upon admission 3/27/25 but was not furnished until 4/3/25.”