Healthcare Facility Compliance 15 items
Hospice Interdisciplinary Group (IDG) Compliance Audit
Audit of hospice interdisciplinary group composition, comprehensive assessment, plan of care, and terminal-illness certification under the Medicare Hospice Conditions of Participation.
42 CFR 418.5642 CFR 418.5442 CFR 418.22CMS Hospice CoPs
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IDG Composition & Coordination
- Does the interdisciplinary group include a doctor of medicine or osteopathy, a registered nurse, a social worker, and a pastoral or other counselor? *
- Has the hospice designated a registered nurse to coordinate the implementation of each patient's plan of care? *
- If the hospice has more than one IDG, is one group designated to establish policies governing day-to-day provision of care? *
Initial & Comprehensive Assessment
- Is the initial assessment completed by a registered nurse within 48 hours of the election of hospice care, unless a different timeframe is documented? *
- Is the comprehensive assessment completed by the IDG no later than 5 calendar days after election? *
- Does the comprehensive assessment address the physical, psychosocial, emotional, and spiritual needs related to the terminal illness? *
- Is the comprehensive assessment updated by the IDG at least every 15 days? *
Individualized Plan of Care
- Is a written plan of care established for each patient before care is provided and reviewed/revised by the IDG at least every 15 days? *
- Does the plan of care include interventions to manage pain and symptoms, and the scope and frequency of services? *
- Are drugs and treatments, medical supplies, and the patient's and family's goals documented in the plan of care? *
Certification of Terminal Illness
- Is the certification of terminal illness signed for each benefit period, with prognosis of 6 months or less if the illness runs its normal course? *
- Does the certification include a brief narrative explanation of the clinical findings supporting the life expectancy? *
- For the third and later benefit periods, is a face-to-face encounter by a physician or nurse practitioner documented within 30 days prior? *
Bereavement & Volunteer Services
- Is an organized bereavement program under a qualified professional available to the family for up to one year after the patient's death? *
- Do volunteers provide administrative or direct patient care in an amount equal to at least 5% of total patient care hours? *
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