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Hospice Administrator

Hospice employee

Has required education and
experience

Responsible for hospice daily
operations

Reports to the governing body
Hospice Services
Physician
Nursing
Medical Social
Services
Counseling
Hospice Aide
Homemaker
Volunteer
Physical Therapy
Occupational
Therapy
Speech Language
Pathology
Inpatient Care
Medical Supplies,
Drugs, Biologicals
DME
Professional Management
Written agreement
Services are
 Authorized by the hospice
 Furnished safely and effectively by
qualified personnel
 Follow the patient's Plan of care
Hospice retains administrative and financial
management, and oversight of staff and
services

Multiple Locations
Be Medicare approved before providing
services to Medicare patients.
 Be part of the hospice.
 Share administration, supervision, and
services with the hospice.
 Have clearly delineated lines of authority,
professional, administrative control.
 Be continually monitored and managed by
the hospice.

Medical Director



Doctor of Medicine or Osteopathy
Employed directly or under contract
Hospice may contract with individual
or group
Medical Director Responsibilities

Medical Component of Hospice’s Patient
Care Program

Review Patient’s Clinical Information

Certify And Recertify Terminal Illness
Clinical Record Content
All assessments, Plans
of Care, Clinical notes
Signed notice of Pt.
Rights, & election
statement
Responses to
Outcome measure data
medications, symptom
elements (from
management, treatments assessments)
and services
Clinical Record Content (Con’t)
Physician
certification and
recertification
Past and current
findings
Physician’s orders
Advance Directives
Pop Quiz

What happens when the patient is
transferred to another M’care/M’caid
facility:

A. The hospice must always send a copy
of the patient’s discharge summary with
the patient.

B. The hospice must always send a copy
of the patient’s clinical record with the
patient.
Durable Medical Equipment

Follow manufacturer recommendations
for maintenance

Develop Policies if no recommendation

Instruct pt/family on proper use

Contract with supplier meeting Medicare
MEMPOS standards
Inpatient Care Limitation

Total Medicare inpatient days can’t exceed
20% of total Medicare hospice days.
Restraints or Seclusion



All patients have the right to be free from
restraint or seclusion imposed as a
means of coercion, discipline,
convenience, or retaliation.
Only used to ensure safety of patient,
staff, or others when less restrictive
interventions not effective
no standing orders or PRN
Restraints or Seclusion





least restrictive possible
Safety is paramount
Time limited
Monitored by trained staff.
Documentation of training available in
personnel records
Hospice/Facility written agreement





Communication and documentation strategy
Facility notifies hospice of specific patient
conditions
Hospice determines appropriate hospice care
Facility responsibility for 24 hour r/b &
personal care
Hospice provides drugs & DME r/t terminal
illness
Hospice/Facility written agreement
(Con’t)




Hospice provide same
services as patients at
home
Hospice use of facility
personnel
Hospice responsibility to
report violations to facility
Provision of bereavement
services
CMS Hospice Center
www.cms.hhs.gov/center/hospice.asp
Hospice Social Worker



MSW from accredited school +1 year
experience
or
BSW, or bachelor in psychology, sociology, or
other related field & 1 year experience &
supervised by MSW
or
BSW AND employed by hospice before
12/2/2008.