IDG signatures before actual IDG date?


I'm a RN Case Manager with a Texas Hospice organization. We have our IDG meetings every week. One week will be for the South side and the next week will be for the NOrth side. All of these meetings occur on Tuesdays excluding holiday days then we choose another day. My concern is that we are made by upper management to fill out and sign off on our IDG doccumentation on Monday by 1400, which is a day before our actual IDG meeting. I feel very uncomfortable signing off a day ahead of the actual meetin. I have others tell me i'm right by questioning the signature date being before actual meeting, and when I question my ED and immediate supervisor all they say is " it is required and expected to be done the day before IDG so the MD can sign off on them on Tuesday during the meeting. Am I worrying for nothing or should I be concerned? I can't find any doccumentation stating it's okay to sign the day before. Please advise.


1,030 Posts

Specializes in MCH,NICU,NNsy,Educ,Village Nursing.

I'm not familiar with the IDG, but, is there a governing board website you can go to and see what is required by law? I don't like to pre-sign anything either. For me it's a bit like signing a contract without reading (or understanding) what the contract says. Anyway---my suggestion is just a thought. Good luck!


7 Posts

I have searched my local nursing board but I havent had much luck at all finding the answer. We all know how quickly pts can die when on Hospice. One of my concerns is that what if that pt died that evening on Monday and i've signed off stating they were still living, or I am out due to accident or illness on Tuesday. So many things tell me it's not appropriate, but I am one who needs to see it in writing of what's legal and what's not. I value my license and the people I take care of.

Thank you

Specializes in LTC, Hospice, Case Management. Has 37 years experience.

Our office is having the same discussion. I'm encouraging nurses to fill out their IDG the day prior to the meeting so they are prepared but all signatures & dates are done at the beginning of the meeting.

klone, MSN, RN

14,578 Posts

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 17 years experience.

My husband is an ED of a hospice - I will ask him. I'm guessing, though, that that might constitute Medicare fraud.

Do you work for a large corporate hospice that starts with an H, by chance?

Okay, from the horse's mouth: An actual IDG meeting is not a Medicare requirement. What is required is that all members of the team update and sign off on the patient's care plan at least every 15 days. So as long as that is being done, Medicare doesn't care when the careplan is signed off on, in relation to the meeting itself.

So, not Medicare fraud, but I'm unclear as to why they would require the signoff the day before. (edited to add: sorry, I went back and reread your OP and I see that it's to facilitate the medical director, so s/he has time during IDG to sign them all).

With regard to "what happens if the patient dies overnight" - I would not sign it with the incorrect date. I would sign it on Monday with Monday's date - you are saying that as of Monday, this is the patient's care plan.

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traumaRUs, MSN, APRN

153 Articles; 21,231 Posts

Specializes in Nephrology, Cardiology, ER, ICU. Has 31 years experience.

Moved to Case Management Nursing.