Using LPNs for visits

[tahijajan]

Having read some threads, I see that some Hospices use LPN's to do visits. I was under the impression that the Medicare rules required the initial nursing assessment upon admission and the mandatory weekly visit to be done by RN's only? Any enlightment would be appreciated!

[RN4ustat, BSN, RN]

I have been taught that the admission must be done by an RN, but the RN only has to see the patient every 14 days. My hospice uses LPN's and it allows me to have a higher case load than the other case managers (not necessarily a good thing) but it can be very advantagous for all parties if the RN/LPN are a good working team.

[nurseratchett29]

I am a LPN in a "start-up" hospice in Mass. I share a caseload with a RN. We have about 20 patients. She does the initial assessments and the biweekly CNA medicare supervisions. Although according to regs I cannot sign careplans or do the initial assessment, I am able to do a lot of other things that are time consuming...For instance, often times, family members are unavailable to sign the hospice consent during business hours or are in an area that my partner is not going to be in on a particular day. I am able to do the signon, review the chart, set up our med list etc. and that takes a lot of pressure off her. We share the visits so that there is always a fresh viewpoint coming. We have a pretty large territory between us so sharing the caseload frees up mileage and makes it easier to do the unscheduled visits that always come up. It balances out also because I am incharge of the CNAs.Although I cannot do Medicare sups. I am basically their direct supervisor who they report to and am in charge of follow up with their cares to make sure facilities and families are happy. I also co ordinate their schedules and track the CNA medicare sups to make sure we are in compliance. It makes for a good fit because we work so well together. I love my job!!!!!