Hospice Aide Supervisory Visit (14-Day)

Inspection template for documenting the RN supervisory visit of hospice aide services at the required 14-day interval, including aide competency, patient care review, infection control, and follow-up actions.

Visit Identification and Interval Verification

• Visit date and time recorded
• RN supervisor identified
• Hospice aide identified
• Supervisory visit completed within required 14-day interval
• Patient or visit location documented

Aide Competency and Task Performance

• Aide demonstrated competent performance of assigned tasks
• Aide followed the plan of care and assigned scope of duties
• Any observed deficiencies or non-conformances documented
• RN provided coaching, retraining, or competency reinforcement as needed
• Evidence of safe patient handling and communication

Patient Care and Safety Review

• Patient condition reviewed for changes or concerns
• Aide observations appropriately escalated to RN or hospice team
• Safety hazards in the care environment identified and addressed
• Patient dignity, privacy, and comfort maintained
• Any immediate follow-up needed for patient care documented

Infection Control and PPE

• Hand hygiene performed at appropriate times
• Appropriate PPE used based on patient care needs
• Infection control practices followed during care
• Any contamination risk or exposure concern documented

Documentation, Follow-Up, and Signature

• Supervisory visit findings documented in the record
• Deficiencies and corrective actions documented
• Follow-up plan or re-education scheduled if needed
• RN signature
• Date of next supervisory visit due