Liaisons/Non-Clincial..Never seen this before!!!!

[CHPNRNTX]

Ok, I have been in hospice for a very, very long time. I am seeing a new trend that is quite troublesome to me..Let me know if any of you are seeing this, and what is their explanation on how this is even legal:

NON-clinical liaisons/marketers...

1. Digging through a patient's chart and obtaining clinicals on patients and then witnessing consents without a RN eval for appropriateness?

2. Upon witnessing consents...leaving date blank or writing upon medical eligibility in the date line?

3. Receiving bonus incentives for admissions........?

4. Witnessing consents days in advance like sometimes a week, and then admission nurse admitting the patient?

When did this become legal/ethical?

[TammyG]

Our liaisons do just about everything mentioned by the OP, and I do not see it as either illegal or unethical. Families are not contacted for consents without an MD order. Patients are not admitted without an RN eval and an HMD order. Start of service dates are never back-dated. I do not understand why paying a liaison based on numbers of hospice starts is illegal, unethical or even a bad idea. I do not believe that it leads to ineligible people being admitted. Don't we want to help as many people as we can?

[jeannepaul, BSN]

Except when they do not meet criteria. I used to work with a marketer that was in cahoots with a certain physician. He would call her from the hospital and half of them didn't meet criteria. They seem to think if they can get an order for eval, they will automatically be admitted. I have been doing hospice since 2002 and to me it seems the criteria doesn't mean diddly squat anymore. We used to have certain diagnosis that was actually a terminal diagnosis. Now I say they do not qualify according to indicators, and they just go around me and admit anyway. No FTT, so protein calorie malnutrition is used. Not end stage dementia because they say more than 6 words, able to wheel herself around and is continent, cerebral degeneration. I think sometimes they would do better without hospice because they would be having routine labs and more aggressive treatment.

[toomuchbaloney]

I was a liaison for a hospice. I was a clinical liaison and I worked in the hospital setting.

I marketed our hospice and managed the care of the GIP patients in the facility. When a person elected their hospice benefit I most definitely participated in the development and execution of the POC, including generating a standard order set for the hospitalist. I grew our population and elevated our brand in a stiffly competitive market. My employer was pleased.

That agency also had nonclinical liaisons who marketed to skilled nursing facilities, assisted living, and provider practices. They too often wrote checks that medicine and nursing or other disciplines could not deliver. The clinical staff had to refer more than one hospice patient to another provider because we could not provide the support services promised.

In those cases, it is not the liaison who is having those discussions with dissatisfied families and patients.

[MSNMPHPhdNMD]

They are the worst!!! We have one clinical liaison and the rest are marketers who have no clinical clue what's going on!!