question about visits

[onewithhospiceheart]

Hi there,

When I worked in home care, if a patient had a physician visit that week, that physician visit would take the place of our visit. Example....if pt was to be seen for home nursing 2x wk, and had a physician appt, we would ony make one nursing visit that week and document that physician visit took place of nursing visit.

Is this practive the same in hospice? Can't find anything in the regs that address this.

Thanks!

[jeannepaul, BSN]

I've worked with 3 hospices in the past 9years, and the physician does not usually make home visits. They will visit if there is a problem but we usually try to do visit with physician. Now the new rule is a face to face at a certain point to recertify but it can be done by NP. I would just do your usual visits and if a special visit by physician is made I wouldn't count it as your visit.

[tommytwice]

As far as being in compliance physician visits are completely different from nursing visits. The main thing to remember is that you need to stay within your projected nursing visits(mine are usually 1-2x/week or 2-3x/week) which are actually MD orders and part of the plan of care. So if the MD visits it really doesn't matter because it's a totally different discipline, you still need to be within the range of your ordered projected nursing visits. Now, if the MD visits and you don't feel the need to visit you can always write an order to decrease the projected nursing visits for a specific weak so you are still in compliance.

tommytwice RN

[tewdles, RN]

ditto...different disciplines make different visits...

so an MD visit does NOT replace an RN visit.

[AtlantaRN, RN]

md's are required to make home visits with the new regs-before a pt is recerted at the six month point, and every 60 days thereafter.....

rn visits are different, so 2x/week is 2x rn visits/week

[onewithhospiceheart]

Hi all, thanks for the replies. I was not actually talking about face to face visits.....I am actually talking about if the patient makes a visit to their physician office. Rarely happens of course, but occassionally we have had that family that decides that they want to take their loved one into the office.

I understand about the disciplines though now, that does make sense.

Thanks for your replies!

[AtlantaRN, RN]

still the same----2 days rn visits/week is still 2 days a week, no matter how many physicians they visit.