Category: Compliance
Articles about maintaining compliance in the field of hospice.
Considerations of Care — Related and Unrelated Diagnoses for a Terminally ill Patient Receiving Hospice Services
Explore the complexities of hospice care for terminally ill patients with multiple diagnoses. Learn how to distinguish between related and unrelated conditions, understand Medicare coverage, and navigate the challenges of providing comprehensive care while adhering to hospice regulations and ethical standards.
Avoiding Problematic Language in Hospice Nursing Narratives
Proper documentation is crucial for hospice nurses to ensure Medicare compliance and maintain the patient's eligibility for services. Auditors, who may not have a healthcare background, review these documents to determine if the patient's condition is terminal. To avoid having the patient removed from service due to improper documentation, hospice nurses should be mindful of the words and phrases they use in their nursing narratives and progress notes. This article will guide what to avoid and why it is essential to paint a picture of a terminally ill patient.
Reviewing Hospice Eligibility
It’s essential to familiarize yourself with the key local coverage determination (LCD) facts for different terminal illnesses to avoid admitting patients who are not eligible for services only to be required to refund the money back to Medicare; otherwise, only have the patient on for one benefit period then discharged for failure to decline. These determinations provide guidelines on the coverage of hospice services for specific conditions. If you are the admitting nurse, please do not just admit because you were told to admit by someone, regardless of the position or standing of the person or party that told you to admit. Use your critical thinking and clinical judgment skills to evaluate the patient for admission. Most doctors will write "evaluate and treat" or something to that effect; never lose sight of the "evaluate" portion of the doctor's order.
Based on the provided PDF files, as noted in the resources section below, let’s explore some essential information for each terminal illness.
Failure to Decline in Hospice – The Good and The Ugly
If your loved one is facing a discharge from hospice due to failure to decline, it's crucial to comprehend the situation clearly. This discharge indicates that the healthcare team believes your loved one's condition has stabilized and no longer requires hospice care. While this might be a positive sign, it's important to weigh the pros and cons before making decisions. Let's delve into both the positive and negative aspects of this situation to help you navigate it effectively.
Empowering Hospice Nurses: Conquering Medicare Audits and Improving Documentation for Better Patient Care
This article provides valuable insights for hospice nurses on improving documentation to conquer Medicare audits and ensure claims are not denied due to insufficient evidence of terminal prognosis. The author shares real-life examples of visit narratives before and after implementing documentation best practices learned from an expert. The tips focus on capturing negative condition changes, disorientation levels, and functional decline to paint a clear picture of the patient's terminal state, ultimately leading to better patient care.
Review of the Hospice Documentation Master Bundle
Whether you are a new hospice nurse or an experienced one like me, I would hope that it is your desire to prove and support continued hospice eligibility for your patients and families. In my years as a hospice nurse, I've always felt the training on what words and phrases to use to support hospice eligibility was weak compared to the training received in other areas of nursing. Now, you have a means of getting the education you need in a very portable setup that you can take with you, use as you see fit, and bloom!
A Day In The Life Of A Hospice Nurse
What does a typical day, a typical week look like for a visiting hospice registered nurse case manager look like?
Understanding HIS Requirements for Medicare in Hospice Care
One crucial aspect for new hospice nurses to grasp is the Hospice Item Set (HIS) requirements. In this article, I’ll explain the HIS requirements for Medicare, providing you with a comprehensive understanding to ensure compliance and quality care delivery.
The Hospice Nursing Visit from a Nursing Perspective — Home Patients
This article offers guidance for new visiting hospice nurses struggling with work-life balance. It covers strategies like maintaining a recertification journal, pre-charting before visits, assessing end-of-life status, educating families, and preparing for a "good death." By following these tips, nurses can take less work home while delivering focused, compassionate care.
Hospice Eligibility and Hospice Recertification — information for families and new hospice nurses
As an experienced hospice nurse, I understand how overwhelming and emotional it can be for terminally ill patients and their loved ones to navigate the hospice process. Hospice care is a compassionate and comprehensive approach to end-of-life care, designed to provide comfort, pain management, and emotional support to patients and their families. However, many people have questions about hospice eligibility and hospice recertification. In this article, I will provide a generalized guide to help you understand these important aspects of hospice care.
What’s the process of getting your loved one on hospice service?
Hospice care focuses on providing comfort and quality of life for people with terminal illnesses and life expectancies of six months or less. While hospice care can be a difficult decision for families, it can also be a source of support and relief during a challenging time. In this article, we will explain the process of getting your loved one into hospice care and answer some common questions.
An example recertification template for hospice eligibility
Hospice recertification is a crucial step in which the registered nurse case manager can help make the case for continued hospice eligibility. May I encourage my fellow hospice nurses to start using a template to ensure your recertification visits are consistent and that you are leading early in the documentation portion regarding what declines have occurred since admission and last recertification?
General Inpatient (GIP) Level of Care for Hospice Explained
GIP, or General Inpatient Hospice, is an often misunderstood aspect of hospice care. Both hospital staff and families sometimes have misconceptions about GIP. Families may assume it's readily available upon request, while hospital professionals may believe it allows patients to remain in the hospital indefinitely, even when death is weeks away. This article will clarify the basics of GIP for hospice, including eligibility requirements, doctor's orders, care plans, documentation, and education. We'll conclude with two real-life cases to illustrate these points.
Tips for new hospice nurses doing an admission
If you are a new nurse to hospice, one of the tasks you probably dread is doing an admission especially if you have scheduled visits the same day as the admission.
I would like to share with you some tips that when applied may help lower your stress level, and help you remain on time even in cases where you have three to four visits including recertification to do the same day.