The longer I work as a hospice registered nurse, the more I understand the value of documenting to support and prove . Sometimes we don't see the forest for the trees as we are out there caring for our terminally ill patient, but if our documentation does not support eligibility the impact can be far greater than whether a patient is admitted, recertified, et al; it can lead to a financial catastrophe for the leading to layoffs and or termination of staff. If we genuinely care about our patients and our families, it is our responsibility to properly document with the goal of painting a picture that supports the patient has a terminal condition and is heading towards death within a time frame typical of the disease process and progression.

In the last few years, I came across Shelley Henry, RN, CPHRM, CHPN – President – The Amity Group on Facebook where she posts tips for hospice nurses several times per week. It is from Shelley that I learned to start documenting “disoriented x3” vs “oriented x1” and the value of negative-based presentations as being terminally ill involves negative (downward) .

This led me to obtain two of the products Shelley developed: “A 's to Hospice Documentation” and “A Supplemental to Hospice Documentation” as part of the Hospice Documentation Master Bundle. Pictures on the Internet rarely provide enough information to ascertain true value. Let me share with you my of these two products as I strongly believe they can help hospice nurses bloom.

Unboxing

The two books came packaged in a protective plastic slip which kept them clean and protected from moisture. I was pleasantly surprised that the size of the main book — A 's Guide to Hospice Documentation — is pocket sized to fit into a scrub pocket; and the A Supplemental Guide to Hospice Documentation, while slightly larger would fit perfectly into a small bag. The primary book is 5.5″ tall by 4.5″ wide. The supplementary guide is 8.5″ tall by slightly shy of 6″ wide.

A Hospice Nurse’s Guide to Hospice Documentation

Pages 1 through 7 cover major areas that are often missed in orientation of new Hospice nurses and includes information I only picked up over the years. Pages 8 and 9 are gems in their own right because you are educated quickly on phrases to avoid as well as how to start thinking about phrases that support eligibility. Pages 9 to 11 start laying the groundwork for the Local Coverage Determination (LCD's) that follow. Pages 12 through 29 are amazing in that you are given the key LCD points with the secret sauce that ties it altogether as to what key areas to document the progression of the disease showing the patient is not only appropriate but is having decline supporting continued . Pages 30 to 36 are scales often used in the field; and having all of this in a guide that fits into one's scrub pocket means there is no reason to ever forget the book.

A Supplemental Guide to Hospice Documentation

This is a supplemental book intended to be used with Hospice Nurse's Guide to Hospice Documentation. This past Wednesday, July 12, 2023, the compliance training group reviewed my recertification note as well as a routine visit note for two separate patients giving me kudos for how well both notes were written, BUT as I the suggestions and examples in the supplement book, if I utilized the suggested tips, phrases, way to think and write… it would be an A++ vs. an A. Imagine for those new nurses who nurses whose had years of nursing in other fields where it was more common to use words like “stable,” “no apparent distress,” and other expressions that mirror “within normal limits” where such words in hospice can end eligibility!

Every major terminal illness is covered with one page going over key areas such as neuro, pain, mobility, skin, elimination, nutrition, self-care, affect followed by a complete example note incorporating those areas. Each area is color coded such that when you read the complete narrative note you can picture the patient and situation in ways that support continued hospice eligibility.

Conclusion

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!

Disclaimer

The author is not related to Shelley Henry or any member of her family, is not employed, or otherwise contracted by the Amity Group, and will not receive any financial benefit from anyone purchasing these products. None of the links on this page are affiliate links.

Resources

The Amity Group Products

The Amity Group on Facebook

Hospice Nurses Speak: How to Attract Us, Keep Us, or Lose Us

The Amity Group Documentation Videos – wonderful tips – on Tic Tok

The Amity Group featured on CW39 Houston

The Amity Group on LinkedIn

The Amity Group on Instagram

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