CAHP90

Hello, you can do what is called a "tuck in" basically you meet the patient there and just make sure they're stable, educate family, take vitals etc. The initial assessment as well as the intial comphrensive is out of your scope of practice and unfortunately can only be done by the RN. As long as you're not charting the initial on your hospice agency's EMR you're fine. Per medicare after admission, the RN has 48 hours to complete the initial assessment. Some agencies do tuck ins due to nursing shortages and not having an RN available the day of admission since most nurses in hospice are per diem/part time. A lot of families/patients have anxiety going into the program so having someone clinical the day of admission helps a little. ?

Hello, this is actually pretty common. If the patient came from the hospital they have their own POLST and e-order on file for DNR. You can ask for a copy if family signs a medical release form. Hospice has to get their own consents signed which includes their POLST and this is to be discussed with family again. Because the reps are on the field usually they get everything signed and scan or email it to the office who then faxes it to the Hospice MD/attending physician which is why there is no signature. Later they send that copy to the SNF. Ideally, the SNF should get this during the same day of admission but I've worked for hospice before and sometimes they can take up to 48 hours. So the physical form itself is not valid since the MD is not present during the consents getting signed. Which is why the RN doing the initial assessment has to write all medication and code status in the SNFs MAR via verbal order and include the MD following the pt into hospice. The patient if is under hospice they need to sign all consents themselves if they alert and oriented if not POA can sign for pt. ? Hope this helps