GentivaLink Hospice Job Aid Hospice Discharge Process

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Hospice Job Aid Hospice Discharge Process ` I. Death Discharge 1. Clinician visits and pronounces 2. Documentation initiated and sent to office (may be two visit notes) 3. MD, IDG, MCP and sales notified 4. Phone Call to HospiScript and/ or DME Supplier 5. MCP Follows up with team to notify of death 6. Death Report Summary and Medication disposal are documented and sent to office II. Revocation 1. Patient informs program of desire to revoke 2. Discus implication and options with patient and family 3. Statement of Revocation is signed by patient 4. MD, IDG, MCP and sales notified 5. Phone Call to HospiScript and/ or DME Supplier 6. Discharge Transfer Summary completed 7. Review case to determine reason for revocation III. Transfer to Other Hospice Provider 1. Patient requests 2. Obtain physician order for 3. Coordinate care with other Hospice provider 4. Obtain signature on Notice of Transfer Form 5. MD, IDG, MCP and sales notified 6. Discharge summary completed 7. Review case to determine reason for IV. Processing 1. HIS form is initiated, validated and completed by MCP 2. Final IDG is completed to close out POC 3. Status is updated in McKesson and with completion of HIS 4. Feed to HospiScript 5. Discharge/ death summary faxed to Attending 6. Final charges generated, FSU notified, NOTR sent End 9/17/15

V. Live for extended prognosis 1. Case Manager or IDG determinations patient may not meet eligibility criteria 2. MCP or Medical Director perform assessment and patient discussed and documented 3. Communicate with Attending Physician 4. Live Extended Prognosis Worksheet Completed and submitted 5. Case discussed at IDG 6. Is a date determined? Yes 7. Patient, family, caregiver discussion regarding 8. Notice of non-coverage is issued and uploaded 9. Document teaching, planning, safety measures to safe (detail is on visit note) 10. Actively coordinate with other service providers needed to meet the needs of the patient 11. Discharge summary is completed and indicates changes not seen that indicate reasonable 12. Discharge order is obtained No 13. Ongoing care is provided 14. Final IDG is initiated and completed to closes out POC 15. HIS form is initiated, validated and completed by MCP 16. Status is updated in McKesson and with completion of HIS 17. Feed to HospiScript 18. Discharge summary faxed to Attending 19. Final charges generated, FSU Notified, NOTR Sent End 9/17/15

Hospice Job Aid I. Death Discharge 1. Clinician visits and pronounces 2. Documentation initiated and sent to office (may be two visit notes) 3. MD, IDG, MCP and sales notified 4. Phone Call to HospiScript and/or DME Supplier 5. MCP Follows up with team to notify of death 6. Death Summary and Medication disposal are documented and sent to office Clinician Person Patient may be actively dying or already passed Clinician Documentation Notes that may need to be completed if at patient home during death process o Continuous Care Progress Note o Nursing Clinical Note Person To stop delivery and arrange for pick up as needed MCP RN Discharge/Death Packet choose correct form o Death Report Summary and Medication Disposal (used if present) o Death Report Summary & Medication Disposal Non Visit See Processing in step IV II. Revocation 1. Patient informs program Patient of desire to revoke 2. Discus implication and Clinician/MCP Person options with patient and family 3. Statement of Revocation Clinician/MCP/ Person is signed by patient Patient 4. MD, IDG, MCP and sales notified 5. Phone Call to HospiScript and/or DME Supplier Person To stop delivery and arrange for pick up as needed 6. Discharge Transfer Summary completed RN Discharge/Death Packet choose correct form Discharge/Transfer Summary Discharge/Transfer Summary Non Visit 1 9/17/2015

Hospice Job Aid 7. Review case to MCP/QA/ED determine reason for revocation See Processing in step IV III. Transfer to Other Hospice Provider Person/Phone Evaluate for any opportunity to improve service 1. Patient requests Patient 2. Obtain physician order for Clinician o Clinician opens Physician Order under Orders/POC in My Forms. o Completes order information o Pushes to Hospice Medical Director o Medical Director signs order 3. Coordinate care with Phone other Hospice provider 4. Obtain signature on Clinician/MCP Person Notice of Transfer Form 5. MD, IDG, MCP and sales notified 6. Discharge summary completed Clinician Discharge/Death Packet choose correct form Discharge/Transfer Summary Discharge/Transfer Summary Non Visit 7. Review case to MCP/QA/ED determine reason for See Processing in step IV IV. Processing 1. HIS form is initiated, validated and completed by MCP by next business day 2. Final IDG is completed to close out POC Person/Phone Evaluate for any opportunity to improve service MCP MCP select the HIS Discharge Form under Office Forms o Enter Caregiver and date o Ensure the Date of Death, Condition, Disposition and Reason are in the form o Enter Reason for Discharge (A2115) o Feeds to Mckesson upon completion Clinician All disciplines review and sign the IDG Hospice Physician reviews and signs MCP marks as complete 2 9/17/2015

Hospice Job Aid 3. Status is updated in McKesson and with completion of HIS McKesson Date, condition, disposition and reason are updated in McKesson. SRC ends associated personnel (hospice specialist), facility and room and board. 4. Feed to HospiScript McKesson Active in HospiScript until midnight. Need contact via drug diversion, continue verbally 5. Discharge/death summary faxed to Attending Records Fax 6. Final charges generated, FSU notified, NOTR sent McKesson See McKesson process V. Live for extended prognosis 1. Case Manager or IDG Person determinations patient may not meet eligibility criteria 2. MCP or Medical Director MCP/MD Person perform assessment and patient discussed and documented 3. Communicate with MCP Person/Phone Attending Physician 4. Live Extended Case Manager Paper See worksheet process Prognosis Worksheet Completed and submitted 5. Case discussed at IDG Person 6. Is a date Person determined? 7. Patient, family and Case Manager Person caregiver discussion regarding 8. Notice of non coverage Case Manager Person is issued and uploaded into 9. Document teaching, planning, safety measures to safe (detail is on visit note) 3 9/17/2015

Hospice Job Aid 10. Actively coordinate with other service providers needed to meet the needs of the patient 11. Discharge summary is completed and indicates changes not seen that indicate reasonable 12. Discharge order is obtained 13. Ongoing care is provided 14. Final IDG is initiated and completed to closes out POC 15. HIS form is initiated, validated and completed by MCP by the next business day 16. Status is updated in McKesson and with completion of HIS Person/Phone Exact time frame for is dependent on patient condition, most should not take longer than 2 weeks Case Manager Person Typically order is obtained on day of. If obtained early must indicate to as of / /, listing the dc date. All disciplines review and sign the IDG Hospice Physician reviews and signs MCP marks as complete MCP MCP select the HIS Discharge Form under Office Forms McKesson o o Enter Caregiver and date Ensure the Date of Death, Condition, Disposition and Reason are in the form o Enter Reason for Discharge (A2115) Date, condition, disposition and reason are updated in McKesson. SRC ends associated personnel (hospice specialist), facility and room and board 17. Feed to HospiScript McKesson Active in HospiScript until midnight. Need contact via drug diversion, continue verbally 18. Discharge summary faxed to Attending Records Fax 19. Final charges generated, FSU Notified, NOTR Sent McKesson See McKesson process 4 9/17/2015