Hospice and GIP admissions

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Specializes in Hospice, Geriatrics, Wounds.

I have recently started working for a new hospice company. For whatever reason, they LOVE to admit patients already hospitalized (GIP). I just don't get it. I thought to admit under "GIP status", the patient had to be having an UNMANAGED SYMPTOM r/t hospice diagnosis. My previous hospice employer NEVER admitted Pts in this manner. When one of our patient's were admitted to the hospital with an admitting dx r/t hospice dx, then they were considered "GIP". If the hospital admitting dx was NOT related, then they remained "routine home care". Anyway, this new company admits 2-3 already hospitalized Pt's a week. I feel like it takes away from our home patients, who truely seem to need us more. We are already very short staffed, and to expect daily visits on a hospital patient can be time consuming (we have very LARGE coverage area, I have put 10,000 miles on my car in just 4 weeks). Any thoughts, anybody???

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

If the percentage of GIP level of care is high for your agency they will be on the radar for scrutiny. The national average for GIP level of care is less than 3% of hospice population...do you know how you would compare?

The bottom line will be whether or not your agency can justify that LOC for each of the patients and whether or not your documentation and interventions meet the criteria for GIP.

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Specializes in Hospice, Geriatrics, Wounds.

Does the 20% GIP cap still count when Pt's are ADMITTED already GIP (and die, say 4-5 days later still GIP?)? I've tried to investigate this myself on medicareuniversity, among other sites. I just want to make sure I know what is going on.....

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Specializes in PICU, NICU, L&D, Public Health, Hospice.
Does the 20% GIP cap still count when Pt's are ADMITTED already GIP (and die, say 4-5 days later still GIP?)? I've tried to investigate this myself on medicareuniversity, among other sites. I just want to make sure I know what is going on.....

Honestly, I had never questioned that!

AND...I don't know the answer. Dang...and I wan't to just have a night "off".

LOL

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Specializes in L&D, Hospice.

we used to have some when i still worked, usually they were in such a state that transport was not feasable or not wanted and death was most often within 24 hrs - we basically made sure the symptoms remained controlled (nothing the hospital staff could not do, however some physicians seemed to listen to hospice recommendations better than hospital staff)

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I know this is an older post, but have to say: 2500 miles/wk (10,000/4 weeks) makes no sense, the amount of hours of driving each day would leave no room for any patient care, certainly there is an error.

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Specializes in Hospice, Geriatrics, Wounds.
I know this is an older post but have to say: 2500 miles/wk (10,000/4 weeks) makes no sense, the amount of hours of driving each day would leave no room for any patient care, certainly there is an error.[/quote']

I CAN ASSURE YOU...THERE WAS NO ERROR IN MY MILEAGE! !!! our office covered 18 counties. And, there was little time for patient care. Service failures were the "norm". Needless to say, I am no longer with that particular hospice company (cmpy B)...luckily I was able to return to my previous hospice job (cmpy A) after working for cmpy B for only a few months. Sadly, that was my second attempt at working for cmpy B. The fraud was rampant, respect very poor, and pt care horrific. It was nothing for me to work 60-70h a week. Yes, those companies do exist. The money was outstanding but not worth the numerous mental breakdowns I endured....not to mention the heartache from seeing pts not taken care of properly. Now that Medicare has forbidden Debility/ AFTT dx, I forsee cmpy B closing within a few months. Ok, praying they will close....as I have heard its 50x worse there now.....

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Medicare has not yet removed those diagnoses.

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Specializes in LTC, Sub-Acute, Hopsice.

But we have gotten multiple "guidance" communications that we should not be using them for billing. We have spent the last couple of months finding a more appropriate diagnosis or working on discharge for the ones we can't change the diagnosis. From what I have read from CMS and the consultants to our company for all things CMS, we can't use them without the billing being sent back for a more specific diagnosis.

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Specializes in Hospice, Geriatrics, Wounds.
Medicare has not yet removed those diagnoses.

Well then use them and see dont you get an automatic audit.

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I just put a patient in an OTC on GOP for uncrotrolled symptoms,dyspena.

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Specializes in NICU/L&D, Hospice.

Wow! That's a lot of miles to put on your personal vehicle for work!! Ouch!

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