Gentiva

“Upon patient record review, 3 of 19 (Patient #1,2,6) 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: During medication reconciliation, the facility and hospice medication profiles did not match. The hospice medication profile contained MiraLAX 17g once a daily as needed, but the facility medication profile contained MiraLAX ordered at twice daily as needed. The facility medication profile also contained orders Lidocaine patch 4% topically every 12 hours as needed and Simethicone tabs 80MG 1 tab before meals and at bedtime. Patient 2: During medication reconciliation, the facility and hospice medication profiles did not match. The facility medication profile contained orders for acetaminophen 2 tabs 3 times a day, guaifenesin every 6 hours PRN for cough, hydrocortisone cream 1% as needed for skin irritation, Lactulose 15ml as needed every 24 hours for constipation, and Mylanta 400-40mg/5ml as needed every 6 hours, Preparation H as needed every 8 hours. The hospice medication profile did not contain those medications. The hospice medication profile contained orders for Lorazepam 0.25ml once a day after lunch and oxygen as needed via nasal cannula but the facility did not have those medications listed. Patient 6: Medication profile has as needed oxygen orders. No evidence that a delivery method was added.”

“Upon patient record review, 1 of 19 (Patient #1) 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. the care and service for each patient and family. Patient 1: No evidence of weekly wound measurements between 12/22/25 through 1/11/2026. Wound was assessed as healed and orders discontinued on 1/22/2026.”

“Upon patient record review, 1 of 19 (Patient #5) 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 5: The medical record indicated that the patient had wounds that were healed on 12/18/25 and 01/05/26. Wound care orders, wound interventions and goals remained active on the current plan of care.”

“Upon patient record review, 3 of 19 (Patient #1,2,6) 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 medications and treatments. Patient 1: The facility medication profile also contained orders Lidocaine patch 4% topically every 12 hours as needed and Simethicone tabs 80MG 1 tab before meals and at bedtime however, the hospice did not have orders for these medications. Patient 2: During medication reconciliation, the facility and hospice medication profiles did not match. The facility medication profile contained orders for acetaminophen 2 tabs 3 times a day, guaifenesin every 6 hours PRN for cough, hydrocortisone cream 1% as needed for skin irritation, Lactulose 15ml as needed every 24 hours for constipation, and Mylanta 400-40mg/5ml as needed every 6 hours, Preparation H as needed every 8 hours. The hospice did not have orders for these medications. Patient 6: The medical record contained as needed oxygen orders. No evidence that a delivery method was added.”

“Upon patient record review, 1 of 19 (Patient #3) 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 3: Aide documentation on 12/22, 12/26, 12/29, 12/31, 01/02, 01/07, 01/12/26, 01/14/26, 01/19/26, 1/23/26, 1/26/26, 01/28/26, 01/30/26, 2/2/26, 2/5/26 indicated that the patient was requesting to only have showers instead of the bed bath on the plan of care. No evidence that the RN updated to the aide plan of care to included the patients request for showers.”

“Upon observation, there was no evidence the hospice is primarily engaged in providing the following care and services: • Nursing services • Medical social services • Physician services • Counseling services, including spiritual counseling, dietary counseling and bereavement counseling • Hospice aide, volunteer, homemaker services • Physical therapy, occupational therapy, speech-language pathology services • Short-term inpatient care • Medical supplies (including drugs and biologicals) and medical appliance Patient #4: Medical record indicated that the LPN added problems, goals, and interventions related to safety to the plan of care. Those problems that remained active in current benefit period that started on 01/27/2026. This is not within the LVN acceptable standards of practice. Patient #9: Medical record indicated that the LPN added problems, goals, and interventions related to GI/constipation to the plan of care. Those remain active in the current benefit period that started on 01/16/2026. This is not within the LVN acceptable standards of practice.”