Tag: Charting

Compliance-based, Eligibility Driven Hospice Documentation: Tips for Hospice Nurses

Compliance-based, Eligibility Driven Hospice Documentation: Tips for Hospice Nurses" offers comprehensive guidance for hospice professionals. This valuable resource provides practical examples for various aspects of hospice care documentation, including admissions, recertifications, IDG/IDT notes, continuous care, and GIP records. Enhance your documentation skills while ensuring regulatory compliance.
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Hospice General Inpatient Care: a Guide for Families and Nurses

general inpatient hospice header
Hospice General Inpatient Care (GIP) provides short-term, intensive care for patients experiencing severe pain or symptoms that can't be managed at home. Learn about GIP eligibility, benefits, and how it helps both patients and families during challenging times. Discover key details and important considerations for this essential hospice service.
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When Death is Imminent – What to Expect from Hospice

Hospice nurses are crucial in comforting and supporting patients nearing death and their families. This article explores what to expect from hospice care, focusing on patient assessments, educational discussions, and addressing common family concerns.
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Compelling Hospice Nursing Narratives: Ensuring Continued Eligibility and Comprehensive Care

This guide covers how to write effective hospice nursing narratives, key documentation areas, and the importance of detailed and negative-based wording to support continued hospice eligibility.
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Admission Nurse: Essential Questions to Ask During the Hospice Admission Visit

Some Indicators For Hospice Eligibility
As a hospice admission nurse, asking the right questions is crucial for assessing patients' eligibility and providing compassionate care. This article explores critical questions to understand the patient's condition, decline timeline, hospitalizations, functional abilities, cognitive status, and comorbidities. By gathering this information, nurses can support informed decisions, tailor interventions, and ensure a "good death" for patients and families.
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Revisiting Time Management for a Hospice Visiting Nurse

Discover essential time management strategies for hospice visiting nurses. Learn how to balance patient care, documentation, and self-care while navigating the unique challenges of rural hospice work. Improve your efficiency and effectiveness in providing compassionate end-of-life care.
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Hospice Eligibility for Diverse Dementia Diagnoses

Differential Diagnosis for Dementia
Exploring Hospice Eligibility Criteria for Alzheimer's, Vascular, Lewy Body, Frontotemporal and other Dementias: Empowering Hospice Nurses to Provide Compassionate End-of-Life Care
Read MoreHospice Eligibility for Diverse Dementia Diagnoses

How RN Case Managers Can Maintain Good Compliance with Medicare Guidelines

As a seasoned hospice nurse, I recognize the significance of adhering to Medicare guidelines to ensure top-notch patient care. Medicare guidelines offer a roadmap for hospice providers to offer exceptional care to terminally ill patients and their loved ones. Nonetheless, upholding compliance with these guidelines can be a hurdle, especially for smaller hospice providers with limited resources. In this article, we'll delve into how RN case managers can effectively ensure compliance with Medicare guidelines.
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Educational Topics for Hospice Nurses During Admission and Post-Admission Visits

Discover essential educational topics for hospice nurses during admission and follow-up visits. Learn how to effectively communicate with patients and families, manage symptoms, provide emotional support, and navigate end-of-life care. Enhance your skills to deliver compassionate, comprehensive hospice care.
Read MoreEducational Topics for Hospice Nurses During Admission and Post-Admission Visits

Understanding Hospice Eligibility for Terminally Ill Patients with Non-Alzheimer’s Dementia

Navigating hospice eligibility for non-Alzheimer's dementia patients demands a personalized approach. Unlike Alzheimer's, there's no definitive scale, necessitating assessments of functional decline, mobility, communication, incontinence, weight loss, overall condition, and comorbidities. Effective documentation, clinical judgment, and compassionate care are crucial for supporting these patients and families.
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Understanding the Patient’s Question: When Will I Die?

Wirlpool
Navigating the tender journey of hospice care, Compassion Crossing offers guidance on addressing the pivotal question of “when?”—a beacon for caregivers seeking solace and understanding in life’s final chapter.
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Documenting Observational Signs of Discomfort: A Guide for Hospice Nurses and Families

Person Writing In A Journal
As a hospice nurse, I understand the importance of documenting observational signs of discomfort in terminally ill patients. This guide covers recognizing physical and behavioral cues indicating discomfort, even if patients don't express it. It also highlights the benefits of journaling for families and nurses, with tips for effective documentation to enhance patient comfort and care.
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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.
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Understanding Heart Failure Stages and Assessment

Heart failure is a complex medical condition that can impact the quality of life of patients, especially those in hospice care. As a hospice nurse, assessing the heart failure stage is crucial to providing appropriate care accurately. This article will explore the New York Heart Failure Classification System, its stages, and how to assess patients for their stages. Additionally, we will emphasize the importance of documentation in compliance with Medicare guidelines for terminally ill patients with heart failure.
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Understanding Functional Decline in the Natural Dying Process

Explore the journey of functional decline in the natural dying process. This article provides insight for caregivers and families, emphasizing the importance of documenting changes to enhance care and decision-making in life’s final chapter.
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Reviewing Hospice Eligibility

general hospice criteria
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.
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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.
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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!
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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.
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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.
Read MoreThe Hospice Nursing Visit from a Nursing Perspective — Home Patients

Hospice Routine Visit Template

I keep the bedside documentation to under 15 minutes (admission visits not included) by creating muscle memory by following consistent templates based on the type of visit (routine, PRN, recertification, death, and admission). I’ve previously shared my recertification template, so let me share my routine visit template for today. For those new, routine visits are scheduled ahead of time, and while you may arrive to find a crisis before you, the visit itself was scheduled and therefore considered routine. It is regarded as part of the four hospice care levels according to Medicare guidelines.
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The Importance of Documenting Hospice Visits at the Bedside

Our primary focus for our patients is comfort at the end of life as hospice nurses. We work tirelessly to ensure that our patients receive the best possible care during their end-of-life journey. An aspect of that care that is often overlooked, but incredibly important is timely documentation. Documenting hospice visits at the bedside is crucial for several reasons. Not only does it help ensure that our patients are receiving the best possible care, but it also helps the hospice team as a whole and reduces issues when the caregiver must be involved in triage services. Here are just a few reasons why documenting hospice visits at the bedside is so important:
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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?
Read MoreAn example recertification template for hospice eligibility

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