Without objective evidence of your patient's decline, you are risking claims denials and your compliance record. HHH MAC CGS offers these examples of quantifiable measures it likes to see in hospice patients' records: - Type (ache, throb, sharp) - Intensity (level 0-10) - Location (upper, lower) - Frequency (hourly, daily) - Medication usage (dosage, frequency) - Occurrences of incontinence - Dress (assisted, unassisted) - Bathe (assisted, unassisted) - Ambulation ability (assisted, unassisted) - Ambulation distance (feet, steps) - Upper arm measurement (inches, centimeters) - Abdominal girth (inches, centimeters) - Respiratory rate (increased, decreased) - Oxygen flow rate (liters) - Hyper/hypotension - Radial/apical pulse (tachycardic, bradycardiac, regular, irregular) - Edema (level 1-4, pitting, non-pitting) - Turgor (slow, normal) - Amount (cups, liters, ounces, teaspoons, mgs, ml, cc) - Frequency. Plus: General quantifiable values to keep in mind are size, time frame, and frequency, CGS suggests. Other values may include head elevation and speech pattern. Note: See the entire documentation tool, which also addresses admission requirements, physician services, and more, at www.cgsmedicare.com/hhh/education/materials/pdf/Hospice%20Documentation%20Tool_H-021-01_07-2011.pdf.