[hospicenurse MO LPN]

I am a hospice LPN in MO. We, LPN's, are utilized heavily and our caseload continues to be added to. We are now allowed to do the admission assessments, and update the plan of care's(there are no signatures signing who it is that updates the POC's). I havebeen informed that this may be illegal through Medicare. Does anyone have any substantial information on this? thanks,
Kim

[morte]

that is were my thoughts were going, even before i read your question....unless regs have changed, i believe that this is the case...good luck

[Tweety]

Hi. I will move your question to the Hospice Nursing forum, since you're asking a question specific to that field. Good luck.

[shrinky]

My concern is not only illegal by Medicare standards, which it is, but also your nurse practice act. Are LPNs allowed to do assessments? Here in SC they have to work with or under an RN and RNs do all admission assessments though LPNs can do revisits and stay with patients and families as death approaches. Please check your practice act.

[lantanaRN]

Hi fellow hospice nurse: in answer to your question, I am a case manager RN,CHPN in Florida, I believe the other posters are correct..only RN's are allowed to do the initial assessment, implement or update the POC, and are required by medicare regs to visit the patient personally at least once every 14 days. in addition. continuous care (crisis care) cases must be supervised by an RN daily, LPN's can staff the case. Sounds like your hospice needs a few RN's

[mc3]

Hello,
I'm a CHPLN in Florida, too. I've initiated POC's on new patients and routinely update POC's. I sign recerts. I can't do admission assessments. I, as an LPN, can pronounce a death, but only if you work for hospice. When I worked up north, I did everything except signing recerts and pronounce. Have worked on an RN/LPN team, but now need a change and have switched to Crisis Care.
mc3

[SpringTXRN]

In Texas LVN/LPN cannot do assessments for an admit but a routine reg assessment...except in nurs homes then the LVN can do admissions with assessments. Never could figure that one out. Good luck

[hospicekt]

I am also a RN in Missouri working in hospice. The RN's role in hospice is to be the case manager, do admission and discharge visits, etc. The LPN should not be creating the plan of care, but is allowed to obtain new orders and document that. But they also need to do and document that they have informed and educated the casemanager of all new changes.

[rnboysmom]

Federal Regulations require the POC to be initiated by the RN (who must assess the patient to do so) Others are correct, you need to check your nurse practice act to ensure you are not acting out of your scope of practice-you are, in this instance) LPN duties vary widely in different hospice companies, many use them as "cost effective" labor and allow them to do anything to even out caseloads. I am, in no way, negating the value of any LPN's expertise or experience. Many of the hospice nursing skills I have obtained have been at the skilled hands of some of the greatest LPN's I know. Protect yourself and your licensure, you can't do much advocating for change if your licensure is pulled for practicing out of the scope of your licensure. Good luck!!!!