Every finding on record at True Heart Hospice and Palliative Care of Texas LLC

It is required that the hospice provides nursing care under the supervision of a registered nurse. This standard was not met as evidenced by clinical record review and interview. In 3 of 8 (38%) clinical records with licensed vocational nurse (LVN) visits revealed that the agency did not ensure that the nursing care was provided under the supervision of a registered nurse. Clinical Record 1: The LVN visited on 5/4/2023. There was no documented evidence of LVN supervisory visit for the RN Comprehensive visits dated 5/8/2023, 5/16/2023, 5/25/2023, and 6/1/2023. Clinical Record 2: The LVN visited on 12/3/2022, 12/5/2022, 1/172023, 2/7/2023, and 2/23/2023. There was no documented evidence of LVN supervisory visit for the RN Comprehensive visits dated 12/13/2022, 12/21/2022, 1/4/2023, 1/12/2023, 1/23/2023, 1/30/2023, 2/13/2023, 2/27/2023, 3/8/2023, 3/25/2023, and 3/30/2023. Clinical Record 5: The LVN visited on 1/19/2023, 2/8/2023, 2/14/2023, and 2/23/2023. There was no documented evidence of LVN supervisory visit for the RN Comprehensive visits dated 1/24/2023, 2/4/2023, 2/6/2023, 2/16/2023, 3/2/2023, 3/13/2023, and 3/24/2023. During an interview on 1/18/2024, the Alternate Administrator/Director of Clinical Services confirmed that the nursing services were not provided under the supervision of a registered nurse. The Alternate Administrator/Director of Clinical Services stated that the LVN supervisory visit documentation will be in the RN Comprehensive Visit note.