md visits in inpatient

[hospicemom]

when you have a patient inpatient hospital does anyone know the requirement for m.d visits? i cant find a medicare policy on it and noone seems to know, including the docs.

[HospicePalliativeRN, RN]

Good question. I work on an acute inpatient hospice unit (non-hospital) that I helped open last year. Because it is an acute unit, our team decided that patients would be seen daily by an MD or NP and that all new patients would be seen within 24 hours of admission. I would think these guidelines either meet or exceed Medicare requirements for acute inpatient care.

Mark

[rnboysmom]

Visits by the MD are set by hospital policy--almost any hospital that has any type of certification requires that MD visits daily for management of the patient within the system. Most hospitals that do not have a palliative care unit have not given thought to what the protocol is when a patient becomes GIP in a hospital setting. Hospital policy is almost always geared towards acute patients and requires daily visits thus mandating that the patient be seen daily.

[Passion for the Job]

I believe if the pt comes to the hospital for acute care (symptom management), they need to be seen daily and within the 1st 24 hours of being brought in. If the pt. is in respite care, they don't have to be seen by a Dr., but are followed by the hospice team with daily visits to maintain their care for hospice and to make sure no one is coming in and ordering aggressive labs or treatment.

I also think it is per hospital standards.

[aimeee, BSN, RN]

The Medicare COPS state that that for GIP the patient must be seen DAILY by A MEMBER OF THE IDT. I am not sure what the changes (if any) will be when the new proposed COPS become official.

We have set up our policy to require daily rounding by the Medical Director AND the case manager. The two of them must then collaborate and decide daily whether the patients condition justifies continuation of this level of care.