Hospice home binfer1/13/2024 "I am constantly asking the director of nursing for feedback on our services and our staff who come into their facilities." "Each facility has a different personality or culture," she says. Showing respect for the long-term care facility's staff and culture is an important part of a good relationship, says Kelly Fischer, RN, SHPN, director of long-term partners at Hospice Care in Madison, WI. Hospice staff can answer questions and provide information to the surveyor that can help the nursing home's survey go more smoothly, Post adds. "Documentation of a hospice patient is very detailed, and surveyors typically review 100% of the chart for our patients," she says. Post says her staff are present at all surveys. "Patient weight loss is a common reason for a citation, but if the documentation supports the weight loss as a normal progression for this particular patient, the nursing home is not cited," Pekarske says. Hospice staff members can ensure that the care plan and documentation of patient care show that some issues, such as weight loss, are expected for a hospice patient, she explains. State surveys of nursing homes have serious implications, and hospice staff members can help nursing homes with surveys that include hospice patients, says Pekarske. "We're in the nursing home to enhance services, not to take over the care of their patients," she adds. "We have occupational and physical therapists on staff that can work with patients, but we try to use the nursing home's therapists whenever possible."ĭemonstrate your confidence in the nursing home staff's ability to provide care, Post says. "In a patient's home, we are teaching family members how to provide some care to the patient, but in the nursing home, we contract with the nursing home to provide some services," she says. The difference between offering hospice services to a nursing home patient and a patient in a private home is the presence of the nursing home staff, says Post. The contract also should spell out who provides certain supplies, equipment, and services to the hospice patient, she adds. A physician order is needed for referral to hospice, and then the patient is evaluated by a hospice case manager to determine if the patient meets the criteria for hospice, she explains. "It describes each facility's responsibilities for the patient's care as well as the procedure for referral to hospice," she says. The contract is very important, Post says. "Our contracts are reviewed and renewed every two years or whenever there is a change in ownership of the long-term care facility," she adds. The hospice contracts with three nursing homes in four counties in the area and several assisted-living facilities, she says. "We have had a nursing home service line for over four years and an assisted living facility service line for three years," says Margo Post, administrative director for long-term care services at Tidewell Hospice and Palliative Care in Sarasota, FL. Even in those states, a relationship with a hospice agency is elective, so developing a good relationship is important to a long-lasting collaboration, she adds. Pekarske, JD, an attorney with Reinhart Boerner Van Deuren in Madison, WI. While there is no federal requirement that nursing homes or assisted living facilities allow hospice agencies access to patients, there may be some states that define "resident rights" as including access to hospice, says Meg S.L. To take advantage of the opportunities offered by collaboration, you must plan and manage these business relationships carefully, sources say. 1Ĭollaboration between hospice agencies and long-term care facilities can mean significant new growth opportunities for the hospice agency, as well as impressive enhancement of services and resources for the long-term care facility's clients and their families. ![]() Research indicates that 22% of nursing home clients who die in a long-term care facility receive hospice services, but approximately one-third of those patients are enrolled in hospice one to two weeks before death, which greatly reduces the benefits that they and their families received. Next month, we look at a hospice agency that has developed an inpatient hospice unit within a long-term care facility.) This issue contains stories related to key issues to address in developing and maintaining relationships between hospice agencies and long-term care facilities, including potential legal risks as well as tips to strengthen relationships. (Editor's note: This month we begin a two-month look at partnerships between hospice agencies and long-term care providers. Identify responsibilities and concerns up front Hospice and long-term partnerships work well with attention to details
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