Hospice and Home Healthcare of Saunders County

“Based on policy and procedure review, personnel file review, and staff interview the hospice interdisciplinary group (IDG) failed to include a qualified social worker, which had the potential to affect medical social services provided to all 15 of the hospice’s patients on census. Findings are: A. Review of the agency policy and procedure titled, Interdisciplinary Team, revised 1/22 revealed: 1. Services are provided to the patients and their families/caregivers through the use of an interdisciplinary team (IDT) approach. 2. Core services are nursing, social work, physician, and counseling/pastoral care which are provided directly by hospice employees. 3. The IDT must include but is not limited to a social worker. B. Review of the hospice’s personnel files revealed the hospice did not employ a qualified social worker. C. During an interview on 6/25/26 at 3:05 PM, the agency’s contracted, qualified Medical Social Worker (MSW) confirmed [gender] does not attend Interdisciplinary Group (IDG) meetings, complete patient assessments, or complete visits with the agency hospice patients. D. During an interview on 6/25/26 at 12:00 PM the Administrator confirmed: 1. The hospice IDG did not include a qualified social worker. 2. The agency’s contracted, qualified MSW does not participate in IDG meetings, complete patient assessments, or complete visits with the agency hospice patients.”

“Based on record review, policy and procedure review, personnel file review, observation of the provision of cares, and staff interview, the hospice failed to ensure the medical social services provided to 14 of 14 (Patient 1-14) hospice patients were provided by a qualified social worker. The census was 15. Findings are: A. Review of the agency policy and procedure titled, Interdisciplinary Team, revised 1/22 revealed: 1. Services are provided to the patients and their families/caregivers through the use of an interdisciplinary team (IDT) approach. 2. Core services are nursing, social work, physician, and counseling/pastoral care which are provided directly by hospice employees. 3. The IDT must include but is not limited to a social worker. B. Review of Staff F’s personnel files revealed: 1. Staff F’s date of hire was 12/7/2020. 2. The file did not include verification that Staff F was certified to practice as a social worker in the State of Nebraska. C. Review of Patient 1’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 4/13/26 through 7/11/26 included orders for Medical Social Worker (SW) 1-3 time per month for 3 months and 2 as needed (PRN) visits to provide psychosocial education and support to patient and family. 2. The IDG (Interdisciplinary Group) Meeting (a plan of care update meeting attended by, and electronically signed by members of the IDG) notes dated 5/26/26 and 6/19/26 did not include notes or signatures of a qualified social worker. D. Review of Patient 2’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 5/25/26 through 8/22/26 included orders for SW 1-3 times per month for 3 months and 2 PRN visits to provide emotional support to patient and family, education on end of life (EOL), and psychosocial support. 2. The IDG notes dated 5/26/26 and 6/19/26 did not include notes or signatures of a qualified social worker. E. Review of Patient 3’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 5/21/26 through 8/18/26 included orders for SW 1-3 time per month for 3 months and 2 PRN visits to provide emotional support to patient and family, education on EOL, and psychosocial support. 2. The IDG Meeting notes dated 5/26/26 and 6/19/26 did not include notes or signatures of a qualified social worker. F. Review of Patient 4’s clinical record revealed: 1. The Plan of Care Order for the benefit periods of 3/20/26 through 6/17/26 and 6/18/26 through 9/18/26 included orders for SW 1-3 times per month for 3 months and 2 PRN visits to provide psychosocial support and education to the patient and family. 2. The IDG Meeting notes dated 6/8/26 and 6/22/26 did not include notes or signatures of a qualified social worker. G. Review of Patient 5’s clinical record revealed: 1. The IDG Meeting notes dated 6/8/26 and 6/22/26 included orders for SW for 2 PRN visit; they did not include notes or signatures of a qualified social worker. H. Review of Patient 6’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 3/26/26 through 6/23/26 included orders for SW 1-3 times per month for 3 months and 2 PRN visits to provide emotional support to patient and family, education on EOL, and psychosocial support. 2. The IDG Meeting notes dated 6/8/26 and 6/22/26 included orders for SW for 2 PRN visit; they did not include notes or signatures of a qualified social worker. I. Review of Patient 7’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 4/15/26 through 7/13/26 included orders for SW 1-3 times per month for 3 months and 2 PRN visits to provide emotional support to patient and family, education on EOL, and psychosocial support. 2. The IDG Meeting notes dated 6/8/26 and 6/22/26 included orders for SW for 2 PRN visit; they did not include notes or signatures of a qualified social worker. J. Review of Patient 8’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 4/26/26 through 7/24/26 included orders for SW 1-3 times per month for 3 months and 2 PRN visits to provide emotional support to patient and family, education on EOL, and psychosocial support. 2. The IDG Meeting notes dated 6/8/26 and 6/22/26 did not include notes or signatures of a qualified social worker. K. Review of Patient 9’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 6/2/26 through 8/30/26 included orders for SW for 2 PRN visits to provide education/emotional support and psychosocial support. 2. The IDG Meeting notes dated 6/8/26 and 6/22/26 did not include notes or signatures of a qualified social worker. L. Review of Patient 10’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 5/26/26 through 7/24/26 included orders for SW 1-3 times per month for 2 months and 2 PRN visits to provide psychosocial assessment and care, provide education and emotional support. 2. The IDG Meeting notes dated 6/8/26 and 6/22/26 did not include notes or signatures of a qualified social worker. M. Review of Patient 11’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 10/14/25 through 12/12/25 included orders for SW for 2 PRN visits to provide psychosocial support and education to patient/family/staff. 2. The IDG Meeting notes dated 11/10/25 and 11/24/25 did not include notes or signatures of a qualified social worker. N. Review of Patient 12’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 4/27/26 through 7/25/26 included orders for SW 1-3 times per month for 3 months and 2 PRN visits to provide psychosocial support and education to patient and family. 2. The IDG Meeting notes dated 6/8/26 and 6/22/26 did not include notes or signatures of a qualified social worker. O. Review of Patient 13’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 7/2/25 through 8/6/25 included orders for SW 1-3 times per month for 3 months and 2 PRN visits to provide psychosocial support and education to patient and family. 2. The IDG Meeting notes dated 7/21/25 and 8/4/25 did not include notes or signatures of a qualified social worker. P. Review of Patient 14’s clinical record revealed: 1. The Plan of Care Order for the benefit period of 4/9/25 through 7/7/25 included orders for SW 1-3 times per month for 3 months and 2 PRN visits to provide psychosocial support and education to patient and family. 2. The IDG Meeting notes dated 4/28/25 and 5/12/25 did not include notes or signatures of a qualified social worker. Q. During the observation of the provision of cares on 6/23/26 at 11:00 AM, Staff F provided a psychosocial visit to Patient 3. R. During an interview on 6/25/26 at 3:05 PM, the agency’s contracted, qualified Medical Social Worker (MSW) confirmed [gender] does not attend IDG meetings, complete patient assessments, or complete visits with the agency hospice patients. S. During an interview on 6/25/26 at 12:00 PM, the Administrator confirmed: 1. The hospice failed to ensure the medical social services provided to Patient 1-14 were provided by a qualified social worker. 2. The qualified MSW does not participate in IDG meetings, assessments of patients, or patient visits.”