Update...

Just know that with Palliative care(which is not hospice)that a nurse will only come once every 4-6 weeks to check on your loved one, so you'll want to keep the skilled nurses if they're coming more frequently.
I've personally never really understood the purpose of palliative care when the care offered is next to nothing.
Now hospice is a whole different program with nurses coming once a week to start, aides coming at least twice a week to bathe your loved one, and you having access to their chaplain, social worker and volunteers.
They also supply all needed equipment, supplies and medications all covered 100% under Medicare.
So you may want to wait until your loved one qualifies for hospice care if you're wanting more care for your loved one.

Sometimes, depending on insurance the order or referral for Hospice or Palliative care has to come from the Primary Doctor not a specialist. So the Liver doctor, a specialist has to send the referral to the PCP so that the PCP can then refer to Hospice or Palliative.

My husband’s palliative care nurse practitioner was able to prescribe medications and essentially became his primary care provider, coming to the house every 3 to 4 weeks. This cut down on other doctor visits as his symptom management needs were met by the NP. I’m assuming the nurses coming are from a home health agency—you can have both at the same time as well as any treatment your mom wants.

I’m not sure why the PCP sent the referral to his specialist rather than a palliative care provider, usually linked with a hospice. Unless maybe they thought the specialist would have a preferred provider?
At any rate, palliative care changed our lives for the better and I’ve been recommending it here since I joined this site after my husband died.

LD should send this referral, forward it, to the general practitioner, or you can.
Then this can be addressed.
If the LD wants to handle referral to palliative, that is fine.
The important thing is that the referral is acted on, not by whom.

Palliative is a medical specialty. If her practioner doesn't participate, isn't trained, he/she will pass your mom to another practioner who specializes in palliative care.
Meanwhile you need to look up "Palliative Care " and "Palliative CARE specialty". This will give you a whole lot of information on what to expect.

These questions you are asking US are best answered by the nurses who are currently coming in.
I am glad this is progressing along for you and I thank you for the update. We always love getting updates.