Every finding on record at Livewell Associates LLC

It is required that hospice care and services provided to patients and families follow the individualized plan of care established by the hospice IDG in collaboration with the attending physician (if any), the patient or patient representative if any of them so desire, and the primary caregiver in accordance with the patient’s needs if any of them so desire. This standard was not met as evidenced by clinical record review and interview. In 1 of 18 (6%) clinical records reviewed for patients with Medical Social Services ordered, the agency did not ensure the Medical Social Worker provided services as ordered on the individualized plan of care. CLINICAL RECORD 5: The patient elected the hospice benefit on 10/30/2024. The plan of care for the benefit period from 01/28/2025 to 04/27/2025, included an order for Medical Social Worker one time per month for three months starting on 02/01/2025. The Social Worker documented Social Service visits on 02/05/2025 and 04/14/2025. The clinical record did not include evidence that a Social Service visit was provided in March 2025. During an interview on 04/30/2025, the Administrator stated she did not know how that visit was missed but she plans on doing some additional education with the scheduler.

It is required that hospice aides are supervised by a registered nurse who makes an on-site visit to the patient’s home no less frequently than every 14 days to: assess the quality of care and services provided by the hospice aide and ensure that services ordered by the hospice Interdisciplinary Group (IDG) meet the patient’s need. The hospice aide does not need to be present. This standard was not met as evidenced by document review, clinical record review, and interview. In 1 of 18 (6%) clinical records reviewed with aide services provided, the agency did not ensure the Registered Nurse documented supervision for the Hospice Aide no less frequency than every 14 days. Agency policy HR.60 (100121) Employee Supervision, required in part, "A registered nurse must make an on-site visit to the patent's home no less frequently than every 14 days to assess the quality of care and services provided by the hospice aide and to ensure that services ordered by the hospice interdisciplinary group meet the patient's needs." CLINICAL RECORD 1: Clinical record review revealed the Registered Nurse documented an aide supervisory visit on 03/06/2025 and the next aide supervisory visit was documented on 03/27/2025, a total of 21 days and 7 days outstanding. During an interview on 04/30/2025, the Administrator stated that they are tightening the process and doing aide supervision visits at every RN visit so no further supervisory visits are missed.