Every finding on record at Louisiana Hospice and Palliative Care,LLC

Based on record review and interview, the agency failed to ensure a registered nurse (RN) made an onsite supervisory visit no less frequently than every 14 days for Patient #2 who was receiving hospice aide (HA) services for 1 (#2) out of 14 sampled patients. --- Findings:   Patient #2.  Review of the patient’s electronic clinical record revealed the patient’s start of care date was 09/27/2023.  The patient’s diagnosis included Alzheimer’s disease. The benefit period reviewed was 11/15/2025 to 01/13/2026. Review of the patient's POC (Plan of Care) for benefit period 11/15/2025 to 01/13/2026 revealed an order for SN effective 11/16/2025 2wk8, 1wk1, 4 prn for urgent symptom management needs/change in condition, (Skilled Nurse visits two times a week for eight weeks, one time a week for one week, four visits as needed for urgent symptom management needs/change in condition.)  Further review of POC revealed a change in SN visit orders.  The order revealed SN effective 12/21/2025 1wk1, 2wk2, 1wk1, 4 prn resume 2wk visits for 12/28, (Skilled Nurse visit one time a week for one week, two visits a week for two weeks, one visit a week for one week, four visits as needed, and resume two visits a week for the week of 12/28.  The patient’s POC revealed an order for HA effective 11/16/2025, 3wk8, 1wk1 (Hospice Aide visits three times a week for eight weeks, one visit a week for one week). The patient's Visit Note Report for the HA (hospice aide) was reviewed, and the aide was performing the visits with the patient as ordered. There was no evidence found from 12/15/2025 to 01/05/2026, (22 days) that the RN made a supervised visit for the hospice aide between this time frame.  On 01/06/2026 at 9:35 a.m., an interview was conducted with S1ED (Executive Director) and after a review of the patient's electronic clinical records, she verified that the RN did not make a supervisory visit for the HA no less frequently than every 14 days.  S1ED confirmed that the RN should have made the supervisory visit within the 14 days.

Based on record review and interview, the agency failed to ensure the patient's written individualized POC (plan of care) was followed as evidenced by the agency failing to ensure CH (Chaplain) visits were made as ordered per the POC for 1 patient (#5), failing to ensure MSW (Medical Social Worker) visits were made as ordered per the POC for 2 patients (#5, #7) and failing to ensure SN (Skilled Nurse) visits were made as ordered per the POC for 1 patient (#9) for 3 (#5, #7, #9) out of 13 sampled patients. --- 1. Patient #5. Review of the patient's electronic clinical record revealed a start of care date 10/20/2022. The patient's admitting diagnoses included COPD (Chronic Obstructive Pulmonary Disease), Asthma, and Chronic Respiratory Failure. The benefit period reviewed was 1/18/2023 to 4/17/2023. Review of the patient's POC for the benefit period 1/18/2023 to 4/17/2023 revealed an order for CH visits effective 1/18/2023 2M2, 1M1, 2PRN (Chaplain visits two times a month for 2 months, one time a month for one month, two visits as needed). Further review of the POC revealed an order for MSW visits effective 1/18/2023 1M3, 2PRN (Medical Social Worker visits one time a month for three months, two visits as needed). Review of the patient's CH visit notes and MSW visit notes revealed that there was no evidence that CH visits and a MSW visit were made for the month of January for the benefit period 1/18/2023 to 4/17/2023. On 2/13/2023 at 1:10 pm, S1ED (Executive Director) reviewed the patient's electronic clinical records and confirmed that there was no evidence that CH visits and a MSW visit were made as ordered per the patients POC for the benefit period 1/18/2023 to 4/17/2023. 2. Patient #7. Review of the patient's electronic clinical record revealed a start of care date 5/31/2022. The patient's admitting diagnoses included Dementia with Lewy Bodies and Dementia with Behavioral Disturbance. The benefit period reviewed was 1/26/2023 to 3/26/2023. Review of the patient's POC for the benefit period 1/26/2023 to 3/26/2023 revealed an order for MSW visits effective 1/26/2023 1M2, 2PRN (Medical Social Worker visits one time a month for two months, two visits as needed). Review of the patient's MSW visit notes revealed that there was no evidence that a MSW visit was made for the month of January for the benefit period 1/26/2023 to 3/26/2023. On 2/14/2023 at 8:10 am, S1ED reviewed the patients electronic clinical record and confirmed that there was no evidence that a MSW visit was made as ordered per the patients POC for the benefit period 1/26/2023 to 3/26/2023. 3. Patient #9. Review of the patient's electronic clinical record revealed a start of care date 9/8/2022. The patient's admitting diagnosis included Hypertensive Heart Disease with Heart Failure. The benefit period reviewed was 1/6/2023 to 3/6/2023. Review of the patient's POC for the benefit period 1/6/2023 to 3/6/2023 revealed an order for SN visits effective 1/6/2023 2wk8, 1wk1, 4prn (Skilled Nurse visits two times a week for eight weeks, one time a week for one week, four visits as needed). Review of the patient's SN visit notes revealed that there was no evidence that SN visits were made for the week of 1/6/2023. On 2/14/2023 at 3:00 pm, S1ED (Executive Director) reviewed the patient's electronic clinical records and confirmed that there was no evidence that SN visits were made for the week of 1/6/2023.

Based on record review and interview, the agency failed to ensure a registered nurse (RN) made an onsite supervisory visit no less frequently than every 14 days for Patient #3 who was receiving hospice aide (HA) services for 1 (#3) out of 13 sampled patients. --- Review of the patients electronic clinical record revealed that the patient was admitted to the agency on 1/6/2023 with the diagnoses that included Hypertensive Heart Disease with Heart Failure and Chronic Respiratory Failure. The certification period reviewed was 1/6/2023 to 4/5/2023. The patient's plan of care (POC) was reviewed and revealed an order for SN effective 1/6/2023 2wk1, 3wk3, 2wk9, 1wk1, 6prn (Skilled Nurse visits two times a week for 1week, three times a week for three weeks, two times a week for nine weeks, one time a week for one week, 6 visits as needed). Further review of the patients POC revealed an order for HA effective 1/8/2023 3wk12, 2wk1 (Hospice Aide visits three times a week for 12 weeks, two times a week for one week). The patient's Visit Note Report for the HA was reviewed and the aide was performing the visits with the patient as ordered. There was no evidence found from 1/24/2023 to 2/14/2023, (22 days) that the RN made a supervised visit for the hospice aide between this time frame. On 2/14/2023 at 11:05 am, an interview was conducted with S1ED (Executive Director) and after a review of the patient's electronic clinical records, she verified that the RN did not make a supervisory visit for the HA no less frequently than every 14 days.