Hospice house question

  1. Our hospice is just starting a new hospice house. Currently our GIP patient's and respite patient's go to the hospital that we are associated with. But now, they will go to the hospice house. The staff at the hospice house are being treated like inpatient (hospital) staff. They received hospital orientation, training on the specific hospital equipment (pumps, glucose monitoring, safe patient handling), hospital protocols and policies, the hospital electronic health record system, etc. Our hospice care managers will still be visiting their GIP patient's daily at the hospice house and less frequently for respite patients. Our hospice care managers feel that they shouldn't have to visit their patient while they are st the hospice house. They feel that the assessment and care from the staff at the house should be adequate for a visit and that it will save the care managers time if they didn't have to see them also. The problem is that we are treating them as inpatient staff and they are documenting on a completely different documentation system. So, they would have to double document (would have to document in our home care documentation system as well).
    I wanted to see what other hospices do that have hospice houses as well. Do the care managers visi the patients? Thank you
  2. 4 Comments

  3. by   Shortone7
    Both of the hospice companies I have worked for do have the case managers visit their patients in hospice house no matter what the level of care is.
  4. by   RNBearColumbus
    I work for a hospice attached to a rather large hospital company in Ohio.

    We have both home hospice, and an inpatient hospice unit with 25 beds.

    I am a hospice case manager, and see my patients in their homes. However, once one of my patients is admitted to the inpatient unit for an acute reason, they are considered to be in the hospital, and I am not expected to see them while they are in the IPU. Even if they go to another acute care inpatient setting, I still would not see them. Once they are discharged, either to home or to a ECF or SNF, they go right back on my case load, and I start seeing them again.

    If they are at another facility for respite care, I would still see them, just like I do my other patients that are residents at a ECF or SNF.
  5. by   bekabsn
    Hello. I work at a stand-alone inpatient hospice unit. When our patients come to the unit under GIP, the home case managers typically do not follow the patient while they are in the unit. However, if the patient comes to the unit for respite, the home team will follow them while the patient is at the unit.
  6. by   vampiregirl
    I work inpatient hospice (freestanding) and our set-up is similar to RNBear Columbus.

    Our regular day shift nurses serve as the "case managers" while the patient is at the hospice home for purposes such as IDT etc. We have a schedule of which shift does a daily comprehensive assessment for which rooms so that every patient has one completed daily (similar to a field visit). Every shift assesses and documents on every patient. When we discharge them either home to a ECF, then the prior case manager resumes his/her role. Same with Social Work and Chaplain services, we have dedicated hospice home staff. We use the same EHR as our field staff, so this is helpful for both hospice home and field staff. Our respite patients from homes typically go to ECF, although in extenuating circumstances they may come to the hospice home. Often our field case managers will "check up" on their GIP patients, but not as a visit. When our patients are discharged to home or ECF we give report to the primary case manager in addition to whomever will be performing the "tuck in" visit (if it's not the case manager). This system works well for us both in efficiency and continuity of care.