As of January 1 2011 Medicare has mandated that all Medicare patients receiving hospice care in the home be seen by a doctor or Nurse Practitioner at each recertification period prior to being recertified.
As a case manager for a non profit company providing hospice care in the home my first thought… what an extra burden on the company already stretched financially. Then my thought was, why doesn’t Medicare trust the nurses…. We KNOW if the patient meets criteria or not. So I ignored the idea and waited to see what might happen.
Yesterday just before leaving the house I received a call from a woman who said ”Hi I’m so-and-so I am about to go to your patient’s house for a “face-to-face”. At first I had no idea who she was nor what she was talking about, that expression had not yet become part of my new knowledge. After some back and forth I finally got the picture. This was a Nurse Practitioner about to make a visit for my company in order to keep up with the new mandate.
We met at Mr. P’s house, entered with the lockbox and announced our arrival. Mr P is very shy, very private and not open to new faces but the NP was very personable right from the start, she was warm and compassionate, took her time and did not rush anything.
The visit lasted an hour and I had questions that she had answers to and the patient had questions that she also answered. It was wonderful having a little support to complement and enhance the work being done. It may sound like I am unsure of myself in my professional practice, I am not, but support and running ideas around help justify the practice being given.
I love this woman! It was the best visit and I now think this is a great idea! I’m not sure every 3 months is necessary, maybe every other certification period (ever 6 months) as there are a lot of people to see, but hey, let’s put these wonderful practitioners to work in the field for support sharing their medical knowledge and let the medical director oversee the multitude of patients under his/her care.
This is a good idea!
by: Gigi Trabant RN CHPM
Home hospice case manager