Palliative Care Admission - SOI/ROM??

mdonohu7

I am wondering if anyone can answer my question regarding increasing the SOI/ROM on patients who are in palliative care admission.  My understanding is, with our concurrent reviews and mortality reviews, it is necessary to increase the SOI and ROM through clarifying further each documentation opportunity to maximize the SOI/ROM and identify mortality drivers to improve the hospitals mortality score and improve the expected vs the observed.  I am new to my organization and they are including palliative care admission reviews (retrospectively) and attempt to increase the SOI/ROM of each patient.  Does this have any impact in our organizations mortality score? 

aimee_van balen_61052

whether or not the Palliative Care Admits impact your Mortality scores would depend on which model you report to. For example they are not included in the Vizient Mortality rankings, but maybe included depending on who you report to. I would contact your quality department to find out who you report to as a start if you do not know. Best of luck!

rwillcutt

The Z51.5 code can only be assigned if the MD substantiates that palliative care is being given.  The care provided must be aimed only at relieving pain and discomfort for the palliative care code to be applicable.  That said, patients with Z51.5 will only be risk-adjusted if it is POA-Y, aka present on admission.  My experience has been that palliative care has had little impact on the mortality scores at my institutions, regardless of POA status, because it is not listed in many of the regression models.  As the previous poster said, you can check and see who you use for your mortality scores and explore their regression models.