Home Health & Hospice Week

Federal authorities will be looking closely at how you interact with nursing homes your hospice patients reside in. Will your practices pass muster?

When Miami-based VITAS Healthcare Corp. provides care to hospice patients in a nursing home, it makes sure the nursing home has a copy ofthe hospice election form, says nurse Cherry Meier, a spokesperson for the organization in Flat Rock, N.C. The form "clearly states that the resident/patient and/or responsible party wants to have palliative rather than curative care," she observes.

Remind your nursing home partners that the NOE will help their paperwork. "With the MDS 3.0 focusing on giving the resident a voice, the election form should provide guidance in determining appropriate goals/interventions," Meier says.

Also: If the patient has an advance directive, "make sure it is in the chart so the nursing home knows what the patient wants," Meier advises. "Then the physician's six-month prognosis certification provides validation that palliative care is very appropriate given the person's stage of illness," she explains.

Documentation of face-to-face physician encounter visits "again supports that even if the person is living longer than anticipated, they are eligible for the benefit," Meier says. "We ensure those documents are in the chart and are signed appropriately. If they are not signed appropriately, the facilitycan't check on the MDS that the person has a sixmonth prognosis."

Helping hand: The MDS 3.0 includes a question as to whether the resident is admitted to the nursing home from hospice or discharged from the nursing home to hospice. "A third field is checked anytime the resident is receiving care from a licensed or certified hospice. That's why the [hospice] election form is so important to the MDS coordinator as they have proof in the chart and can check those boxes," Meier explains.

Tip: You can help nursing homes identify more patients who are eligible for and would benefit from hospice services. "The MDS 3.0 pain section and mood section are potential indicators that a resident may benefit from a referral to hospice," Meier explains. "When residents talk about being depressed or better off dead or hopeless, etc. -- these are common themes in people who are dying."