A few questions for the group

[LaurieCRNP2002, MSN, RN, APRN]

Hi everyone, hope all of you are well. I have a few questions for the community here.

1. For those RN's that are case managers--does your agency also use CRNP's as case managers or are the nurse practitioners exclusively utilized for face-to-face visits for recerts?

2. Again, for case managers, especially those coming from other specialties: 1) How long was your orientation? 2) Did your orientation include going out with other nurses--not just other CM's but the on-call nurses as well? 3) Did the orientation follow the "core curriculum" for hospice and palliative care RNs or did your organization have their own materials that were given to incoming CM's when they started work?

3. Another question for the CM's--what is your typical caseload?

4. What is the communication like between team members? The organization I work for has a daily conference call Mon-Fri but more often than not, nurses may not find out that one of their patients has passed until they hear it on the "stand-up" call. Does the weekend administrator on-call notify the case managers if one of their patients dies?

5. What EMR system does your hospice company use?

That's all the questions I can think of at the moment. There may be a follow-up post down the road :)--of course I had a few questions in my head but they seemed to escape as I was composing this post, LOL. I will thank everyone in advance for responding to my post.

Laurie--hospice RN/CRNP

[pmabraham, BSN, RN]

Good day:

1. RN's as case managers. Medical director is an MD and CRNP/NP's help the medical director, but don't "case manage."

2. Our agency allowed for up to 8 weeks; I was in the field in about 4; it's up to the individual CM as to how long do they need to orient.

3. Combination of curriculum adding up to over 25 CEU's.

4. Our agency handles caseload differently than other agencies. Typically you will here x-y # of patients per CM. While we have that for IDG purposes - right now as we have an RN on LOA, we are about 25:1 which is high (normal is 10 to 15:1), our patient care coordinator schedules the RN CM's who see anywhere from 4 to 6 patients on light days and 7 to 8 patients on heavy days. When fully staffed, it's 4 to 6.

5. We use an encrypted text system to communicate through the day as well as phone calls. We have IDG every other week (14 days vs. Medicare guidelines of 15 days). We have mandatory staff meetings monthly. Every business day, we have stand up and stand down. Whoever is on call gives an on-call report the morning of the business day (secure text and during stand up).

6. If a patient dies during day shift, the RN CM goes even if not previously scheduled (unless they are overloaded with patients), otherwise the on-call RN CM goes. The exception is if the patient dies at a SNF; in that case, the RN CM (or on-call RN CM) handles the death visit remotely unless the SNIF asks the RN CM t come in.

7. Home Base Point Care.

Thank you.

[nuangel1, BSN, RN]

Good day:

1. RN's as case managers. Medical director is an MD and CRNP/NP's help the medical director, but don't "case manage."

2. Our agency allowed for up to 8 weeks; I was in the field in about 4; it's up to the individual CM as to how long do they need to orient.

3. Combination of curriculum adding up to over 25 CEU's.

4. Our agency handles caseload differently than other agencies. Typically you will here x-y # of patients per CM. While we have that for IDG purposes - right now as we have an RN on LOA, we are about 25:1 which is high (normal is 10 to 15:1), our patient care coordinator schedules the RN CM's who see anywhere from 4 to 6 patients on light days and 7 to 8 patients on heavy days. When fully staffed, it's 4 to 6.

5. We use an encrypted text system to communicate through the day as well as phone calls. We have IDG every other week (14 days vs. Medicare guidelines of 15 days). We have mandatory staff meetings monthly. Every business day, we have stand up and stand down. Whoever is on call gives an on-call report the morning of the business day (secure text and during stand up).

6. If a patient dies during day shift, the RN CM goes even if not previously scheduled (unless they are overloaded with patients), otherwise the on-call RN CM goes. The exception is if the patient dies at a SNF; in that case, the RN CM (or on-call RN CM) handles the death visit remotely unless the SNIF asks the RN CM t come in.

7. Home Base Point Care.

Thank you.

about the same we are currently down a admit nurse, case manager and a clinical manager and a fulltime oncall person.so we are really busy ,i am a casemanager,so we covering oncall and admit .we dont have stand down