social worker visit?

[mschelee, MSN, RN]

Does anyone know the medicare rules on how soon after an admission the social worker has to visit a home patient? At IDG someone said that t medicare requires the social worker to visit a patient within 24 hours of a patients admit, but we couldnt find the regulation? Are they required to visit, or make contact?

Anyone know?

[PoetOfMyHeart]

I was told by an RNCM that the social worker has 3 days to make a visit. I assume this is Medicare regulation, but I'm not positive.

~Sara~

[mschelee, MSN, RN]

As a RNCM I need to find the reg on this.

[sclpn]

in our facility social workers have 5 days to do initial assessment

[ErinS, BSN, RN]

Our hospice rules are 5 days.

[Ramoo]

There is no requirement by Medicare. I called Medicare to verify this after a hospice company told us there was a requirement. I was on the phone for quite a while with medicare to make sure they understood my question about a medicare requirement for a social work to call/visit hospice patients. They said there is none.

My husband was on hospice for less then a week. He did not want to see a social worker nor a chaplain and specifically told the nurse to NOT have anyone call. Unfortunately the social worker from the company ignored the nurse and called anyways. There were other problems with this company that were unacceptable and as a result my husband revoked hospice.

There is no requirement even though companies try to tell you there is. Doesn't give us a very trustworthy feeling about hospice.

[mschelee, MSN, RN]

I am so sorry to hear this, but thank you for the information.

[PoetOfMyHeart]

that is unfortunate, and i am sorry for the unnecessary stress in that difficult time for you and your husband.

that happens sometimes with the company i work for as well. the RNCM and/or the PATIENT will specifically ask the SW not to come by for reasons such as not to over-stimulate the pt or just the pt's request, and sometimes that SW will go on ahead and drop in during the initial assessment! it's frustrating for the RNCM, bad for the companies reputation, and of course unnecessarily stressful to the pt.

~Sara~

[annacnatorn]

If the family says no to a MSW or Chaplain or CNA...then it's NO. No regulations, If the Family says they do not want a specific part of the pie, then it is to be documented in the Nurses Notes, made part of the CP. The MSW and Chaplain can make documentation that the Nurse reported "refual of visit at this time".

All of the Hospice Nurses I have been with have always made sure to revisit the refusal/request at a later time, say 3 days when the shock and awe factor has somewhat worn off a little. Sometimes the Family is to overwhelmed at admission and to add more people into the pot is an overload. I have been to homes where the family has said.."Do you have a SW or a Chaplain that can come?"...I quickly call the requested individual in front of the family, schedule an appointment, then call the NCM and DON re: family request. Many Happy endings when handled this way.

I have found it offensive to the Family when the MSW says that she/he is gonna drop by the house to just check in on them...Please don't. The Family considered it an invasion of their personal rights and as part of the Nursing Support Staff, when we go to the home, WE have to deal with the negative comments. Please wait. I know they have a job to do, it is their calling in life, I respect that 100%..but there needs to be respect on the other side as well. As a CNA, I've been refused visits as well, sometimes I've been asked to just call and check in on them, ask if they have any questions, get them answered, then remind them of the services that are available to them. Usually after the first few days, life is good with the family and they welcome additional visitors.

[volsfan]

Per the COPs:

The initial assessment must be done within 48 hours, by an RN.

The comprehensive assessment must be done within 5 days; this includes the psychosocial (social worker) and spiritual (chaplin) assessment. The family can defer the social work and chaplain, so this would be documented as part of the comprehensive assessment; and as an RN we do assess for spiritual and psychosocial needs.

However, a hospice company can have a policy that is more strict than the COP guidelines.

Hope this helps.

[mschelee, MSN, RN]

thank you!

[chortron]

who determines the frequency of social worker visits in hospice. I have been told by the owner of my hospice company that I need to submit a request to conduct a prn visit after the regular visit with in the same month. Can they do that?