Gentiva I

“Upon patient record review, 4 of 19 (Patients #5,#6,#7,#8) did not have evidence in the patient record that a review was completed of all prescription and non-prescription medications. Patient 5: The medication profile contained ammonium lactate topical cream with no area defined for administration. Patient 6: During home visit medication reconciliation, the facility and hospice medication profiles did not match. The facility profile had an Advair inhaler active which was discontinued by hospice on 9/25/25, levsin every 4 hours PRN compared to hospice every 6 hours PRN, lorazepam 0.25 mg compared to hospice 0.5 mg, mirtazapine 15 mg compared to hospice 7.5 mg, and Tylenol 650 mg scheduled daily that was not on the hospice profile. Patient 7: During home visit medication reconciliation, the facility and hospice medication profiles did not match. The facility profile had Senna-S compared to hospice regular Senna, and Robitussin that was discontinued by hospice 5/6/26. The hospice medication profile also contained two differing frequencies for scheduled morphine. Patient 8: The medication profile contained calmoseptine topical ointment with no area defined for administration.”

“Upon patient record review, 2 of 19 (Patients #8,#10) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient 8: The medical record contained nursing documentation since admission identifying the patient required a mechanical soft diet. The plan of care identified the diet as regular. Patient 10: The medical record contained nursing documentation since admission identifying patient use of a condom catheter at night. There was no evidence of problems, goals, and interventions related to the catheter use included in the plan of care.”

“Upon patient record review, 4 of 19 (Patients #5,#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 5: The medical record contained an order for ammonium lactate topical cream with no area defined for administration. The record also contained nursing documentation upon recertification 7/1/26 identifying patient use of a CPAP. There was no evidence of an order for CPAP use and parameters. Patient 6: During home visit medication order reconciliation, the facility and hospice orders did not match. The facility record had an active order for Advair inhaler which was discontinued by hospice on 9/25/25, levsin every 4 hours PRN compared to hospice every 6 hours PRN, lorazepam 0.25 mg compared to hospice 0.5 mg, mirtazapine 15 mg compared to hospice 7.5 mg, and Tylenol 650 mg scheduled daily that was not in the hospice record. Patient 7: During home visit medication order reconciliation, the facility and hospice orders did not match. The facility record contained an order Senna-S compared to hospice regular Senna, and an active Robitussin order that was discontinued by hospice 5/6/26. Patient 8: The medical record contained an order for calmoseptine topical ointment with no area defined for administration.”

“Upon patient record review, 2 of 19 (Patients #1,#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 1: The medical record contained nursing documentation since admission identifying patient use of a hospital bed, full rails, over bed table, and oxygen. There was no evidence of orders for the DME included in the plan of care. Patient 11: The medical record contained nursing documentation upon recertification assessment 7/27/26 identifying patient use of a shower chair, wheelchair, and Hoyer Lift, and the record contained an order for nebulized medication. There was no evidence of orders for the DME included in the plan of care.”

“Upon patient record review, 6 of 19 (Patients #1,#2,#7,#8,#11,#14) did not have evidence that a revised plan of care includes information from the patient’s updated comprehensive assessment and must note the patient’s progress towards outcome/goals from the plan of care. Patient 1: The plan of care identified the patient as both full code and DNR. There was no evidence the plan of care was updated to eliminate the full code status when the DNR order was signed 4/26/26. Patient 2: The medical record contained nursing documentation 6/17/26 identifying patient use of oxygen. There was no evidence the plan of care was updated to include problems, goals, and interventions related to oxygen safety. Patient 7: The care plan contained interventions related to Macrobid use for a UTI in June. There was no evidence the plan of care was updated to resolve the issue after treatment. The medical record also contained nursing documentation 7/18/26 identifying patient fell resulting in a right hip fracture causing the patient to be bedbound. There was no evidence the plan of care was updated to identify the injury and related needs. Patient 8: The plan of care included an added diagnosis for DNR code status. There was no evidence the plan of care was updated to remove the Advance Directive identification from none to DNR. Patient 11: The plan of care included problems, goals, and interventions related to a wound on the left buttocks. There was no evidence the plan of care was updated to resolve the issues when the wound was healed 8/3/26. Patient 14: The medical record contained an order 8/10/26 for oxygen. There was no evidence the plan of care was updated to include problems, goals, and interventions related to oxygen safety.”

“Upon client record review, 4 of 19 (Patients #1,#5,#6,#12) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient 1: The medical record contained an order for nursing visits twice weekly. There was no evidence of a second visit completed the week of 6/28/26. Patient 5: The medical record contained an order for social work visits twice monthly effective 7/20/26. There was no evidence of a second visit completed in July. Patient 6: The medical record contained an order for volunteer visits once weekly effective 8/3/26. There was no evidence of volunteer visits completed. Patient 12: The medical record contained an order for volunteer visits once weekly. There was no evidence of a volunteer visit completed since 7/27/26.”

“Upon patient record review, 3 of 19 (Patients #1,#7,#11) did not have evidence in the patient record that hospice aide assignments and duties are specific to the patient’s needs. Patient 1: The medical record contained nursing documentation upon admission identifying the patient requires a maximum assist of two for transfers. The aide care plan contained a task to transfer without instructions for assistance needed. Patient 7: The medical record contained nursing documentation identifying a right elbow wound resolved 7/30/26 and coccyx wound resolved 8/5/26. The aide care plan contained instructions regarding the wounds without evidence of updates after their resolution. The aide care plan also contained instructions regarding patient ability to walk independently despite nursing documentation that the patient has been bedbound since a hip fracture 7/18/26. Patient 11: The medical record contained nursing documentation 8/3/26 identifying a left buttocks wound resolved. The aide care plan contained instructions regarding the wound without evidence of an update after the resolution.”

“Upon patient record review 1 of 19 (Patient #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 12: The medical record contained an order for aide visits four times weekly effective 8/11/26. There was only evidence of one visit completed and a missed visit the week of 8/11/26 that stated the aide was off on medical leave. There was no evidence of agency attempt for substitution or rescheduling to meet the ordered frequency.”