Gentiva

“Upon patient record review, 4 of 14 (Patients #4,#6,#9,#10) 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 oxygen with no delivery method. Patient 6: Upon observation during the home visit medication reconciliation, the facility and hospice medication profiles did not match. The facility list did not contain an albuterol inhaler, duoneb, lorazepam, and miralax identified on the hospice profile. Corrected on site. Patient 9: Upon observation during the home visit medication reconciliation, the patient did not have albuterol nebulizing solution in the home. There was no evidence the nurse recognized the missing medication during request of refills two days prior. Corrected on site. Patient 10: Upon observation during the home visit medication reconciliation, the facility and hospice medication profiles did not match. The facility list did not contain an albuterol nebulizing solution and lorazepam identified on the hospice profile. Corrected on site.”

“Upon patient record review, 1 of 14 (Patient #2) 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 2: There was no evidence of a bereavement assessment. Corrected on site with completion 3/19/25.”

“Upon patient record review, 2 of 14 (Patients #3,#7) did not have evidence that a Registered Nurse is designated to ensure continuous assessment of the patient and family’s needs and to coordinate activities with other members of the interdisciplinary group (IDG). The IDG must work together and is responsible for supervision of the care and service for each patient and family. Patient 3: There was no evidence of weekly wound measurements since 2/19/25, as required per agency policy. Patient 7: There was no evidence of weekly wound measurements from 3/7/25 to 3/17/25, as required per agency policy.”

“Upon patient record review, 6 of 14 (Patients #1,#2,#5,#6,#9,#10) 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 admission identifying patient use of a hospital bed and over bed table. There was no evidence of orders for the DME included in the plan of care. Corrected on site. Patient 2: The medical record contained nursing documentation upon admission identifying patient use of hospital bed, bedrails, shower chair, and wheelchair. There was no evidence of orders for the DME included in the plan of care. Corrected on site. Patient 5: The medical record contained nursing documentation since admission identifying patient use of a cane. There was no evidence of an order for the DME included in the plan of care. Corrected on site. Patient 6: Upon observation during the home visit, the patient had a wheelchair and shower chair. There was no evidence of orders for the DME included in the plan of care. Corrected on site. Patient 9: The medical record contained nursing documentation since admission identifying patient use of a hospital bed, wheelchair, and raised toilet seat that were confirmed during home visit. There was no evidence of orders for the DME included in the plan of care. Corrected on site. Patient 10: Upon observation during the home visit, the patient had a broda chair, hospital bed with rails, and over the bed table. There was no evidence of orders for the DME included in the plan of care. Corrected on site.”

“Upon patient record review, 1 of 14 (Patients #11) did not have evidence the hospice offers bereavement counseling that includes: • Making bereavement services available to the family and other individuals in the bereavement plan of care up to 1 year following the death of the patient. Bereavement counseling also extends to residents of a SNF/NF or ICF/IID when appropriate and identified in the bereavement plan of care • Ensuring that bereavement services reflect the needs of the bereaved • Development of a bereavement plan of care that notes the kind of bereavement services to be offered and the frequency of service delivery Patient 11: There was no evidence bereavement care plan tasks including providing information on support groups and invitation to memorials were completed for both bereaved family members. There was also no evidence of monthly contact completed unless declined by the high risk bereaved family member.”

“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: There was no evidence of the competency assessment for the required tasks observed with the aide performing on a patient or pseudo patient. Obtaining required vital signs was corrected on site.”