Lakes Region Visiting Nurse Association
A hospice in Meredith, New Hampshire 03253
186 Waukewan St, Meredith, New Hampshire 03253. (603) 279-6611.
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The short answer
Record last released by CMS on Oct 23, 2026.
- 2 deficiencies cited in the last three years
- 4of 5 family caregiver rating
- 10of 10 CMS’s Hospice Care Index
Each figure’s source sits beside it, in its section below.
What these words mean3
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
What did inspectors find?
2 deficiencies cited in the last three years
The middle of the 5 hospices serving ZIP code 03253 had 1.5.
The last inspection on record was on Feb 14, 2024: a recertification inspection by the state.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
CMS, Hospice ZIP Data. Released Aug 26, 2026. Updated quarterly.
When those deficiencies happened
2 deficiencies in 1 month of the last 36. Last cited Feb 2024. Most serious: Standard-level. The last 3 years, to Oct 27, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | Nov | Dec | ||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
Each deficiency, as cited
Rule titles as CMS’s inspectors cite them, set in sentence case.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Feb 14, 2024: recertification inspection by the state2 deficiencies
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Supervision of hospice aides (42 CFR 418.76(h)(1)(i))
The inspectors’ words, 164 words
“Based on medical record review and interview, it was determined that the agency failed to supervise the quality of care and services provided by hospice aides no less frequently than every 14 days for 1 of 14 patients reviewed for hospice aides in a survey sample of 19 patients (Patient Identifier #16). Findings include: Review on 2/14/24 of Patient #16’s hospice aide visits revealed the following visit dates: 12/19/24, 12/22/24, 12/26/24, 1/5/24, and 1/9/24. Review on 2/14/24 of Patient #16’s nursing visit notes revealed that on-site visits by a registered nurse to assess the adequacy and care of the hospice aide services were completed on 12/15/23 and 1/9/24, revealing that 25 days had elapsed between assessments. Review also revealed that a nurse visit was completed on 12/19/23 and a telephone call was completed on 1/2/24 but no documentation evidence that hospice aide supervision had been performed. Interview on 2/14/24 at approximately 12:30 p.m. with Staff A (Director of Clinical Operations) confirmed the above findings.”
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Criminal background checks (42 CFR 418.114(d)(1))
The inspectors’ words, 110 words
“Based on interview and record review it was determined that the agency failed to complete a criminal background check prior to employment for 1 out of 5 employees reviewed (Staff B). Findings include: Review on 2/14/24 of Staff B’s (Medical Director) employee file revealed that Staff B started employment on 7/31/23. Further review of Staff B’s employee file revealed that Staff B’s criminal background check was completed on 8/31/23. Interview on 2/14/24 at approximately 8:45 a.m. with Staff A (Director of Clinical Operations) confirmed the above finding. Staff A revealed that Staff B was in training from 7/31/23 through 8/31/23 and did have access to patient records during his/her training.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Feb 14, 2024 | Recertification inspection by the state | 2 deficiencies cited |
Is it certified?
- Medicare-certified hospice since May 3, 2018.
- Ownership: non-profit.
- No For hospices, home health agencies, hospitals and dialysis facilities, CMS writes deficiencies at two levels. Standard is the usual one; condition-level is the more serious, when a problem is serious enough that the provider doesn’t meet a whole condition of taking part in Medicare. Source: CMS, State Operations Manual. deficiency or CMS’s most serious finding: the place’s failure to meet a rule caused, or was likely to cause, serious injury, harm, impairment or death to someone in its care. Source: CMS; 42 CFR 489.3. on record in the last three years.
CMS, Hospice General Information. Released Aug 26, 2026. Updated quarterly.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Has anything been proven against it?
- CMS doesn’t publish fines or other penalties for hospices, so none are shown.
- 0 deficiencies cited in the last three years came from inspections that included a complaint investigation.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
Who does the caring?
- From Medicare claims (Jan 1, 2023 to Dec 31, 2024): 15.4 nurse care minutes per routine home care day, 11.8% of skilled nursing minutes at weekends and a visit near death for 96.1% of patients who died.
- Where its patients were cared for (Jan 1, 2024 to Dec 31, 2024): 56% at home, 33% in assisted living, 7% in a nursing facility, 4% in a skilled nursing facility.
CMS, Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | This provider |
|---|---|
| Nurse care minutes per routine home care day | 15.4 min |
| Skilled nursing minutes at weekends | 11.8% |
| Visits near death | 96.1% of patients who died |
Who owns it?
- 10 owners or officers are people: Erin S Jospe (corporate officer); Erin S Jospe (managing employee (on the payroll)); Marc Bard (corporate director, 0%); Katherine Landry (managing employee (on the payroll)); Robert Ciardi (corporate director, 0%); Lisa Kennedy-Sheldon (corporate director, 0%); James Harnett (corporate director); James Harnett (managing employee (on the payroll)); John C King (corporate director, 0%); Tristan Wihbey (managing employee (on the payroll)).
- No private-equity firm among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, Hospice All Owners and Hospice Enrollments. Released Sep 29, 2026. Updated quarterly.
What do families say?
- Family caregivers rate it 4 of 5 in CMS’s survey (Oct 1, 2023 to Sep 30, 2025): 86% rated it 9 or 10 out of 10, and 89% would definitely recommend it.
- CMS’s Hospice Care Index: 10 of 10 (Jan 1, 2023 to Dec 31, 2024).
- 89.89% of patients were assessed on all seven of CMS’s measures at the start of care (Oct 1, 2024 to Sep 30, 2025); 77% had visits from a nurse or social worker on at least 2 of their last 3 days (Jan 1, 2023 to Dec 31, 2024).
CMS, CAHPS Hospice Survey and Hospice Provider Data. Released Aug 26, 2026. Updated quarterly.
| Measure | Rating |
|---|---|
| Family caregiver survey ratingCMS star rating from its survey of patients’ family caregivers, 1 to 5 | 4 of 5 |
| Hospice Care IndexCMS’s Hospice Care Index, 0 to 10 (higher is better): a point for each of ten measures from Medicare claims on which the hospice meets CMS’s threshold | 10 of 10 |
How does it compare nearby?
- Of the 5 hospices CMS’s data show serving patients in ZIP code 03253, where this hospice’s office is, the middle number of deficiencies cited in the last three years was 1.5; this one had 2.
CMS, Hospice ZIP Data. Released Aug 26, 2026. Updated quarterly.
CMS, QCOR hospice inspection reports. Released Oct 23, 2026. Updated quarterly.
| Place | Deficiencies, 3 years |
|---|---|
| Lakes Region Visiting Nurse Association This hospice | 2 |
| Granite VNA, Inc. | Not given |
| Pemi-Baker Community Health | 0 |
| Compassus - Greater Manchester | 2 |
| Quality Care Home Health & Hospice | 1 |
What the record doesn’t say
- CMS doesn’t publish fines or other penalties for hospices, so none are shown.
- Only complaints that led to a citation appear; complaints that didn’t aren’t published.
- CMS ended its Special Focus Program for hospices with serious problems on Feb 14, 2025, so no hospice is marked as one.
- Hospice quality measures have a gap from October 2025: CMS replaced its patient assessment then, and public results from the new one (HOPE) are expected around November 2027.
Sources
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Centers for Medicare & Medicaid Services, Hospice General Information (yc9t-dgbk).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice Provider Data (252m-zfp9).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, CAHPS Hospice Survey (gxki-hrr8).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, QCOR hospice inspection reports (Hospice Survey Reports - Oct 2021 through Sep 2026.xlsx).
Released Oct 23, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice All Owners (e983965e-1603-4cb8-82b5-c40090e380d1).
Released Sep 29, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice Enrollments (25704213-e833-4b8b-9dbc-58dd17149209).
Released Sep 29, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Hospice ZIP Data (95rg-2usp).
Released Aug 26, 2026 and checked Oct 27, 2026. Updated quarterly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Oct 27, 2026.
From the hospice
The public record above comes first. Anything the hospice adds will appear here, below it, and say who wrote it.
Replies
None. Replies aren’t open yet. When they open, the hospice will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.
Paid listing
None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the hospice”, and paying will never change a finding, a rating or the order of results.