Eli's Hospice Insider

• Creating an implantable cardioverter defibrillator policy can save your patients from needless shocks. Mount Sinai School of Medicine researchers discovered that hospice patients with ICDs rarely have them deactivated at admission. This can result in dying patients receiving electrical shocks from the devices.

In the study, which was published in the March 2, 2010 issue of the Annals of Internal Medicine, researchers determined that only 20 percent of hospice identified patients with ICDs on their intake forms and only 10 percent had a policy to discuss deactivation with the patient and family. And 60 percent of hospice patients with an ICD did not have the device deactivated.

• The need for a physician narrative may be new, but you must still follow the old guidelines for obtaining physician certification for hospice.

Certifications may be completed up to 2 weeks before hospice care is elected," RHHI Palmetto GBA says in its Hospice Coalition Questions and Answers from its December meeting.The hospice must obtain oral or written certification by two calendar days after care is initiated.

The written cert must be on file before you bill for the care, Palmetto adds. For subsequent periods, the hospice must have the oral or written cert two calendar days after the first day of the period. Again, the written cert must be on file before submitting a claim.