Please help me understand a 60 days recert vs 90 day hospice benefit

[Momto3CT]

I am new to home care hospice nursing in Ct. I am trying to figure out the difference between 60 day recert ( all new orders???) vs the hospice 90 day certification period. Do I need to do new orders at 90 days too? Thanks so much for helping me understand what I am supposed to do.

[mc3, ASN, RN]

When the pt is first admitted, they are on 2 90-day period recerts, then 60 day recerts thereafter. You don't really need a new order at each recert, you need to have your team physician sign the recertification form if they are still hospice appropriate.

Hope that helps!

mc3:paw:

[tewdles, RN]

Unless your agency is practicing in a way that I am unfamiliar with, you only have to generate another assessment to recertify that the patient remains appropriate for hospice care and services. It is paper work for the case nurse. The Plan of Care is reviewed but not rewritten. The medication list is reviewed but not rewritten.

In hospice there are 2-90 day cert periods followed by unlimited 60 day certification periods. If you think about it, it makes sense...

A patient must have 2 docs sign that if that patients health decline continues on the current path, unchecked, that person will most likely be dead within 6 months. The law says that we have to re-examine that person in 3 months...are they still dying?...if so then continue care. Then again in another 3 months...which puts that patient at that magic "dead in 6 months" window we ask is this patient dying? If the answer is yes the team signs off on the clinical evidence to support that decision to recert.

If the answer is "no" these are the perfect intervals to discharge patients back into the traditional medical POC.