The surveys established as a result of the IMPACT Act are coming and before your hospice can pass with flying colors, it will help hospice administrators to know where others have failed. Key to understanding the pitfalls is the Centers for Medicare and Medicaid (CMS) Top Ten Hospice Survey Deficiencies for 2014.
Smart hospice professionals would be wise to see where others fell short so they can avoid the same fate. Understanding what the most common deficiencies were will help you formulate a plan for addressing any issues your hospice may have and work to get those corrected before your survey. Here are key areas where deficiencies were found and what you can do to ensure your hospice won’t make similar mistakes.
1. Make Sure Your Plans of Care Are Complete
Make sure your Interdisciplinary Group (IDG) works together to create an appropriate, individualized plan of care for each patient with input from patients and their families. Records and clinical notes should be current, organized and reflect active engagement of your IDG. Describe how care is coordinated, delivered and evaluated to ensure quality.
2. Document Drug Profiles
Make sure prescriptions, over-the-counter medications, and supplements are noted in the patients’ drug profile along with any drug therapies that require lab monitoring. Include notes on effectiveness, side effects, drug interactions or reactions, or any changes in dosages. Document all pain and symptom management protocols and communication with patients and their families.
3. Supervise Hospice Aides
A registered nurse must make a supervisory on-site visit at least every 14 days to assess the quality and adequacy of care and services provided by the hospice aide. The nurse is responsible for observing and ensuring the adequacy of the aide services for the patient and family.
4. Conduct Comprehensive Assessments
Keep comprehensive assessments current–at least every 15 days or more, if required–by documenting the patient’s progress and response to care. This will ensure that the hospice IDG has the most current, accurate information about the patient/family to aid their planning decisions.
5. Coordinate Services
The hospice IDG must coordinate the hospice care of the patient with the patient’s medical care providers and document communication with the patient’s attending physician. In addition, homemaker services must be coordinated and supervised by a member of your IDG.
6. Ensure Quality Assessment & Performance Improvement (QAPI)
Be prepared to show how you use the data elements in planning care, coordinating services in your QAPI program. Key staff and hospice administrators must explain the documentation system and be able to retrieve specific data elements.
By understanding where survey deficiencies occur most often, you will be better prepared to address them before your survey. Preparation, organization and the completeness of your documentation will be key to passing your survey with flying colors. To get more tips about hospice surveys, download our free guide: Who Does What? Roles & Responsibilities for the CAHPS Survey.