In the last blog we talked about all of the enhancements with hospice providers and we skimmed over administrative and clinical risk exposure.
The first risk is uninformed benefit election. To avoid risks you should include an election statement that contains essential information and disclosure like a clear explanation of the scope and nature of hospice, effective date of the election, term of benefits, and waiver of Medicare benefits related to treatment of the terminal illness while enrolled with Medicare hospice, and reiterate the patient’s basic right to change providers or revoke benefits.
Failure to certify patients as terminally ill. A well-documented certification processed with evaluations from the physician is needed to correctly diagnose that a patient is terminally ill.
Inappropriate level of care. Routine home care, continuous home care, respite care and general inpatient care are the four levels of care. Providers should be paying close attention to the hospice patient’s levels of care because they tend to decrease and sometimes it is a rapid decrease.
Denial of access to services. Routine covered services, limitations on care, and inpatient care are three aspects of patient’s care that the patients need to understand face to face and written.
Deficient care planning and related documentation. IDG members can more accurately depict care provided and patient status by making certain that hospice care records include patient/family discussions, interventions, clinical findings and notes regarding patient’s conditions and comfort, communication with physicians.
Unsupervised volunteer staff. Volunteers must be properly trained and have established roles and always work under a supervisor.
Lack of coordination between hospice and aging services providers. Successful planning and following strategies like establish joint dedicated teams to coordinate care and serve residents in a consistent manner, sticking with an established schedule, creating opportunities for regular dialogue and communication, designating one person to serve as a connection to the aging services organization, and exchanging regular information on the quality of the partnership, in terms of a client, organizational and regulatory expectations, will make a successful care plan.