COP's

[Sabby_NC]

has anyone heard of the changes coming soon about patient's care that we look after in long term care facilities etc?

we heard yesterday that they are to be looked after as though they are still in their own homes which will bring changes for us in the way we care for them.

lab draws which i try to steer away from as i find it invasive for these terminally ill people. sometimes necessary yes but is it that important? i had one md wanting a cholesterol check!! ok gimme a break here lol

ok i digress....

we will be responsible for the lab draws, foley changes and dressing changes etc that the facility staff do at this time. not to mention anything else that comes up related to the patient's care.

the facility that i am involved with are awesome and are always so happy. they do the decub dressings, lab draws, foley changes etc as part of their care for the pt.

i know this is going to add to my work load immensely as my case load is ever increasing.

i can see the reason for this as holistic care from hospice for our hospice patients but wow all of these changes are interesting to say the least.

one of my collegues only works in facilities with hospice patients and i know she will be running her toosh off with all the things that she will soon be responsible for!

has anyone else heard of this and if so what are your thoughts?

i am interested to hear what others have to say. thanks :)

[marachne]

I haven't read the whole report -- 700+ pages is a bit much for me right now, but what I have heard is that while it's going to be challenging, it's A LOT better than it could've been. Apparently the majority of those 700+ pages are responses from CMS about the comments they received during the public review period -- they did listen. They're also allowing a much longer adoption time than originally planned

A good place to get a tiny bit more information is here. "Hospice Guy" is the director of a hospice agency, and always has good comments, even if you don't agree w/them all. He also mentions workshops and webinars, so see if your agency is going to do that. I think this is a great quote from that article:

"Between these new regulations, the new billing requirements, the proposed hospice rate cuts, and the possibility of major changes in our payment system on the horizon, I really encourage those of you who are still trying to do hospice in a bubble to come on out and join the rest of the movement. NHPCO is working very hard to keep the industry safe, and they could really use your dues. You could also use their help! I promise you, you are going to be needing help over the next 6-9 months!

No, I do not work for NHPCO. Actually, if you review this blog's history, you'll probably find that I have not always been a fan of NHPCO, but we are well past the time where hospices can try to go it alone. We need to speak with one voice, and NHPCO has worked very hard to be that voice for all of us."

Hope that helps a little...

[rockchalk_jayhawk]

the way i understand the new cop's relating to snf/nf or icf/mr is that the hospice will provide medical direction and management of the patient. you will utilize the facilities staff in a manner that you would utilize a family member. it is the responsibility of the nursing facility to meet the personal care and nursing needs that would have been provided by the primary care giver in the home.

presently we have a patient who's daughter works in a clinic. she does all the patients lab draws. is this acceptable, "yes". is the staff at the nursing facility properly trained to do lab draws? if the answer is yes, then i think it is totally acceptable to have them do your lab draws. this would stand true for giving them their routine medications and treatments.

[aimeee, BSN, RN]

I haven't finished reading through all of the new final rule yet but really what you quoted above is what hospices should have been doing all along.

Hospice Guy's blog is great! Thanks for the reminder. Its been a while since I last checked him out.

[Mazzi]

The hospice I work for have been working on updating the way we do things for the past few months. Things are really going to change. Some are good and some will be very difficult to comply with. One of our local facilities is not at all happy with our changes. But they need to prepared due to the COP's will next be made to fit the facilities so when all is said and done, the plan of care should match. EVERYONE that works for hospice needs to start now getting used to the changes. Hope this can open some eyes to changes to come.....