RE: [MARKETING] [EXTERNAL] Inpatient Hospice Patients
I also review all patients including the rare ones in an inpatient hospice status. Here if a patient is admitted to inpatient hospice or are made inpatient hospice prior to midnight on the day of admission, they do not impact our 30 day mortality rates, but it has to be documented within the time frames indicated above.
The challenge here is that I believe according to CMS guidelines for inpatient hospice (and someone please correct me if I'm wrong here) that for a patient to be in an inpatient hospice status they have to be treated for an uncontrolled hospice related condition, i.e. pain management, that cannot be done at the home or free standing hospice setting. Also normally their care is managed by a hospice physician and nursing staff.
Also, if I recall correctly, payment will be based on an inpatient hospice rate vs. a DRG and as I mentioned above SOI/ROM really doesn't matter since this population won't normally impact your hospitals overall scoring. You will have to decide if these patients need the review or not, but again, things may be different outside the VA so I will look forward to seeing other responses to this.
Robert
Robert S. Hodges MSN, BSN, RN, CCDS
Clinical Documentation Improvement Specialist
Aleda E. Lutz VA Medical Center
1500 Weiss Street, ATTN PAS-136
Saginaw MI 48602
989-497-2500 x13101
Robert.Hodges2@va.gov
VA Core Values: Integrity, Commitment, Advocacy, Respect, Excellence (“I CARE”)
VA Core Characteristics: Trustworthy, Accessible, Quality, Innovative, Agile, Integrated
"The difference between the right word and the almost right word is the difference between lightning and the lightning bug." Samuel "Mark Twain" Clemens
The challenge here is that I believe according to CMS guidelines for inpatient hospice (and someone please correct me if I'm wrong here) that for a patient to be in an inpatient hospice status they have to be treated for an uncontrolled hospice related condition, i.e. pain management, that cannot be done at the home or free standing hospice setting. Also normally their care is managed by a hospice physician and nursing staff.
Also, if I recall correctly, payment will be based on an inpatient hospice rate vs. a DRG and as I mentioned above SOI/ROM really doesn't matter since this population won't normally impact your hospitals overall scoring. You will have to decide if these patients need the review or not, but again, things may be different outside the VA so I will look forward to seeing other responses to this.
Robert
Robert S. Hodges MSN, BSN, RN, CCDS
Clinical Documentation Improvement Specialist
Aleda E. Lutz VA Medical Center
1500 Weiss Street, ATTN PAS-136
Saginaw MI 48602
989-497-2500 x13101
Robert.Hodges2@va.gov
VA Core Values: Integrity, Commitment, Advocacy, Respect, Excellence (“I CARE”)
VA Core Characteristics: Trustworthy, Accessible, Quality, Innovative, Agile, Integrated
"The difference between the right word and the almost right word is the difference between lightning and the lightning bug." Samuel "Mark Twain" Clemens