Good questions! I'd be interested to know more about the regulations themselves.
I know that IDT/IDG review and update of each patient's care plan must occur a minimum of every 15 days per Medicare guidelines.
If you haven't already looked at the NHPCO website, they have a lot of good resources for regulations and interpretive guidelines.
The hospice I previously worked for the entire hospice team (nurses, manager, spiritual care, social work, medical director etc) all attended the entire meeting for all the patients on the entire service. Volunteer input was submitted to the volunteer coordinator who presented it on behalf of the volunteers. This hospice had patients who used their own physicians (not the medical director) in most cases, communication was faxed to them for review/ signature. We survived a Medicare audit with no issues that I recall regarding IDT.
I currently work inpatient hospice, all patients are under the care of one of our hospice physicians. The physician, social worker, manager and spiritual care sit through the entire meeting and the nurse case managers rotate in just for their patients. In this case, the primary nurse case managers are the day nurses. This agency is pilot site for Medicare Choices Program, I'm guessing that Medicare only uses sites with strong histories of quality and compliance for pilot sites. This agency also has a strong quality/ regulatory department and provides frequent education.