New Hospice LPN needs help

Specialties Hospice

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Specializes in Pediatrics, Hospice.

Hi,

I am newly hired by hospice through a staffing agency and I did receive orientation from a hospice office, but I know that I need some more help! :eek: Can anyone tell me what is the correct way to document for them? I was told that Medicaid is very strict and I need some examples please. Thanks so much :)

Melissa LPN

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Specializes in LTC, Psych, Hospice.

Your agency should show you the correct way to document. At my company, our forms are very nice! Lots of things to check off and the actual note is just to mention anything out of the ordinary, and it's always ended with "continue current POC" unless, of course, the POC needs to be changed. As part of orientation, my DON will have the new nurse go with me to make visits for three days. First day they shadow me and the next two days, I have them do everything and just make suggestions. Hope this helps!

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Specializes in Pediatrics, Hospice.

Thank you! It does help. My problem is I'm not shadowing anyone and I'm brand new to Hopsice. I worked in pediatrics before so this is a whole new ball game. I was just told that the documentation is very strict and that you have to be careful of what you say or Medicaid will not pay my employer. So it made me a little nervous. I have search online and read all the other posts about hopsice and can't find anything specific to charting for medicaid and what they really want. I am fairly new to nursing so I am still learning a lot! I start tonight so Hopefully I will find something. If there are any LPN Hospice nurses out there that can help, please do! :confused:

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Well, my goodness, they need to be more explicit! Did you shadow with anyone? Can you get them to help, or perhaps your supervisor? Someone in the education department? If it's that important to them - and it sounds like it is - they should be helping you more, and you need to keep on them until you feel comfortable.

mc3:)

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I recently started a hospice case with my regular agency and they told me just to chart the normal way. They gave no explicit instructions otherwise, except to call the hospice nurse if I have any problems or questions. Of course, there is no contact number anywhere for the hospice nurse. I am going to come up with a contact number for the hospice nurse and do just as I was told about my documentation.

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One time I was told to make certain I charted something a minimum of once every two hours. I would suggest you follow that rule. If nothing else, you should probably be repositioning the patient every two hours. I would also make certain to address the issue of pain management and look for anything else that is emphasized on the care plan.

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My agency taught me, that we always chart to the decline. So if you see a pt who is bright and alert that particular day, also include that this is the first time in the past 3 days or that the alert day is an exception to the pts norm. The other phrase they also refer to with charting is "why hospice, why now", to show the need for hospice services and what is going on to show the 'now'. IE: Ms. Smith ate 75% of two meals today, continues with weight decrease r/t usual intake of less than 25%.

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Specializes in LTC, Psych, Hospice.
Hi,

I am newly hired by hospice through a staffing agency and I did receive orientation from a hospice office, but I know that I need some more help! :eek: Can anyone tell me what is the correct way to document for them? I was told that Medicaid is very strict and I need some examples please. Thanks so much :)

Melissa LPN

How is the new job going, Melissa?

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