24 hr coverage at the end

The mother of a very close friend in Ohio just passed away on Monday...the hospice was with the pt around the clock...I was really surprised...we make daily visits when our pts are at the final stages, but we do not have coverage around the clock except for the on call RN...how many of you out there offer this to your pts???

The mother of a very close friend in Ohio just passed away on Monday...the hospice was with the pt around the clock...I was really surprised...we make daily visits when our pts are at the final stages, but we do not have coverage around the clock except for the on call RN...how many of you out there offer this to your pts???

We are working on it. If the family is particularly distressed and not coping well we try to. Staffing is really a bugaboo though. NHPCO is offering an audio/internet virtual conference on Tuesday March 23 on how to start up and run a continuous care program. Fee is per dial in so if you have a number of people interested it is economical. Monday is the last day to register without getting socked with a huge last minute registration penalty fee.

http://www.nhpco.org/i4a/pages/index.cfm?pageid=4203#March23

The mother of a very close friend in Ohio just passed away on Monday...the hospice was with the pt around the clock...I was really surprised...we make daily visits when our pts are at the final stages, but we do not have coverage around the clock except for the on call RN...how many of you out there offer this to your pts???

We are working on it. If the family is particularly distressed and not coping well we try to. Staffing is really a bugaboo though. NHPCO is offering an audio/internet virtual conference on Tuesday March 23 on how to start up and run a continuous care program. Fee is per dial in so if you have a number of people interested it is economical. Monday is the last day to register without getting socked with a huge last minute registration penalty fee.

http://www.nhpco.org/i4a/pages/index.cfm?pageid=4203#March23

We will do continuous care, if the family is having a particularly hard time. We staff it with a combination of RN/LPN's and HHA's. There's a certain % time that's required to be covered by skilled nursing, and the rest can be done w/HHA's. I don't know what the % is for sure, I want to say 50% SN and 50% HHA's.....

Momcats3

We don't do it, though it some situations we will offer transfer to our inpatient unit.

The question on the CHPN exam about continuous care was one of the (??????????) questions for me. What's Medicare define as continuous care? I dunno...

In order to qualify as a continuous care day there must be a minimum of 8 hours of direct nursing care and at least 50% of the hours must be provided by a licensed nurse, the remainder may be provided by a HHA.

Continuous care is considered Level 2 care under Medicare Conditions of Participation. Therefore it should be available to all patients in a Medicare Hospice.

Our hospice has done continuous care a few times in the past. Like everyone else reports, it's been difficult for us to staff 24 hour care. Also, the way I read the regs, it's not meant to be used routinely for every patient, but rather in a situation where the caregiver(s) can't cope or physically do the care needed. There has to be good documentation of the need for 24 hr care, as Medicare pays more for it.

I have also read about a hospice program that uses volunteers for around the clock support at the end. Possibly Hospice of the Florida Suncoast? Can't remember, it's the end of a long work day.

Gail