Gentiva II

“Upon patient record review, 6 of 19 (Patients #1,#5,#6,#8,#11,#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 1: The medication profile contained morphine scheduled hourly instead of as needed in error. Patient 5: The medication profile contained docusate scheduled twice daily, however the instructions identified the medication to be administered as needed if the patient did not have a bowel movement. Patient 6: During home visit medication reconciliation, the facility and hospice medication profiles did not match. The facility profile contained a Biofreeze gel for knee pain scheduled twice daily for application that was not on the hospice profile. The hospice medication profile contained two listings of MiraLAX without instructions that the as needed dose is in addition to the scheduled dose. It was unclear if the scheduled dose 6/7/26 had been changed to as needed 7/10/26 but agency confirmed it was added without instructions specifying to be taken together. Patient 8: The medication profile contained nystatin topical with no area defined for administration. Patient 11: The medication profile contained Tylenol scheduled every 4 hours in error. The medication was a PRN, not scheduled. Patient 13: During home visit medication reconciliation, the facility and hospice medication profiles did not match. The facility profile contained oxygen scheduled at bedtime in addition to the PRN order on the hospice profile, scheduled NovoLog in addition to the sliding scale order on hospice profile, and protonix twice daily instead of hospice frequency of once daily.”

“Upon patient record review, 1 of 19 (Patient #6) 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 6: The plan of care contained inaccurate problems, goals, and interventions related to oxygen use. The patient does not have oxygen.”

“Upon patient record review, 6 of 19 (Patients #1,#5,#6,#8,#11,#13) 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 1: The medication order for morphine was scheduled hourly instead of as needed. Agency confirmed this was in error. Patient 5: The medication order for docusate had conflicting frequencies of scheduled twice daily, however the instructions identified the medication to be administered as needed if the patient did not have a bowel movement. Patient 6: During home visit medication reconciliation, the facility and hospice medication orders did not match. The facility contained an order for Biofreeze gel for knee pain scheduled twice daily for application that was not in the hospice record. The hospice medical record also contained two orders for MiraLAX without instructions that the as needed dose is in addition to the scheduled dose. It was unclear if the scheduled dose 6/7/26 had been changed to as needed 7/10/26. Patient 8: The medication order for nystatin had no area defined for administration. Patient 11: The medication order for Tylenol was scheduled every 4 hours instead of as needed. Agency confirmed this was in error. Patient 13: During home visit medication reconciliation, the facility and hospice medication orders did not match. The facility had orders for oxygen scheduled at bedtime in addition to the PRN order, scheduled NovoLog in addition to the sliding scale order, and protonix twice daily instead of hospice frequency of once daily.”

“Upon client record review, 3 of 19 (Patients #3,#13,#17) did not have evidence that the IDG ensures that the care and services are provided in accordance with the plan of care. Patient 3: The medical record contained an order for social worker visits once monthly. There was no evidence of a visit made in June. Patient 13: The medical record contained an order effective 6/8/26 for spiritual care visits twice in June. There was no evidence of a second visit completed. Patient 17: The medical record contained nursing documentation 12/16/25 identifying the RN instructed the patient’s wife to administer 2 tabs of Levsin and order was for 1 tab every 6 hours as needed.”