RE: [MARKETING] [EXTERNAL] Inpatient Hospice Patients
We have an acute inpatient unit and a palliative care unit. Patients in the hospice status have an order for hospice in either setting. It really doesn’t matter as far as the setting goes, but to be acute inpatient it normally means they need a lot more supportive care and intensive symptom management. At my prior facility we had two designated medical floors which could accept inpatient hospice patients where the staff received training on hospice care, but no dedicated beds.
To be excluded they have to have that order before midnight the day of admission. They are usually moving from an outpatient hospice status/setting or a decision is made with the patient/family to go to a hospice status on the day of admission. Normally, as you said for uncontrolled symptom management.
Coders assign a hospice/palliative care code and admitting puts in something to indicate the hospice status after the provider writes the order for inpatient hospice. The external review agency will then look for the exclusions based on the order and code. The order must be there for the exclusion to occur since not all of our palliative care patients are hospice patients. QM monitors it retrospectively.
Hope this helps.
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
To be excluded they have to have that order before midnight the day of admission. They are usually moving from an outpatient hospice status/setting or a decision is made with the patient/family to go to a hospice status on the day of admission. Normally, as you said for uncontrolled symptom management.
Coders assign a hospice/palliative care code and admitting puts in something to indicate the hospice status after the provider writes the order for inpatient hospice. The external review agency will then look for the exclusions based on the order and code. The order must be there for the exclusion to occur since not all of our palliative care patients are hospice patients. QM monitors it retrospectively.
Hope this helps.
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