A true ES Alzheimer's pt should not be able to walk, talk, maintain an independent sitting posture, or smile. Speech should be limited to a few words. Should have comorbities, and a secondary condition like recurring UTI's, aspiration pneumonia, Stage III - IV pressure ulcers, or serious weight loss over a short time.
Sadly, this patient does not seem to meet the criteria.
As far as "routine lab work"....NO its NOT COVERED under the hospice benefit. Now, if they were talking about a PT/INR r/t Coumadin use, then that particular test would be covered under her traditional Medicare. But, to just do routine labs for the sake of checking them (blood count, electrolytes)...absolutely not along with the hospice philosophy of care. So what if the labs are not WNL? As a hospice pt, we expect exactly that. There would be no intervention to correct the abnormal labs....right?
However, if the pt goes to her primary doctors office, and they do routine labs, her traditional Medicare will likely pay. We, at our office, do not draw them in the field, or pay for transport to primary drs office.
You should consult your team at IDG, and voice your concerns. Im sure you are not the only one wondering if this pt should remain under care.
Just curious....is the pt a DNR? If not, have you discussed code status with her family? What kind of response did you get?