Each year the Centers for Medicare and Medicaid Services (CMS) releases a list of the top ten errors that hospice agencies were cited for in the previous year. The list is meant to be a guide for hospice providers to know the common mistakes that are made so they can be avoided. The hospice team at Axxess knows that most hospice professionals want to spend their time providing compassionate care rather than filling out documentation. That's the reason Axxess built a hospice software that has compliance at its core.
This blog series will outline each of the top ten survey deficiencies identified by CMS and the features in Axxess Hospice that will help providers stay compliant.
Individualized Plan of Care
One of the top survey deficiencies CMS found during 2018 was the failure to follow an individualized plan of care established by the interdisciplinary group (IDG). Axxess Hospice enables the creation of these individual plans and features a clinical note that will indicate whether the patient, their family member, and the IDG team members have been educated about the Plan of Care. This is included in the comprehensive assessment documentation for all members of the IDG team so. This ensures everyone is aware of what the patient and family understand about the hospice care provided. The IDG summary in Axxess Hospice can also be sent to the attending physician to enhance the collaboration and stay compliant.
Terminal Illness Management
Hospice agencies also have a requirement that the individualized plan of care includes all the services that will be used to manage a terminal illness or condition. Hospice IDG members are required to - but frequently do not - document all the services that they are providing to manage the care of their terminally ill patient. To make it easy for them to document the care that they are providing, Axxess Hospice enables users to send the narrative from their visit notes directly to the IDG notes for each patient. This enables seamless documentation that captures the care provided at the time it was provided.
Aide Supervisory Visits
CMS also cited agencies that did not have a registered nurse visit a patient's home to evaluate the care provided by the hospice aide at least once every 14 days. The scheduling dashboard in Axxess Hospice will alert administrators if a patient has not had an aide supervisory visit in more than seven days. The Supervisory Visit Note can be accessed directly from the RN and LVN Nursing Note in Axxess Hospice.
Comprehensive Assessment Timing
When a patient elects to receive hospice care, CMS guidelines require that the IDG team completes a comprehensive assessment within five days. This is another area where a citation is issued for compliance failure. Timing is important in hospice care, which is why Axxess Hospice has built-in features to enable agencies to stay compliant. The software dashboard has a section with alerts when a patient changes status within the last 24 hours. This will help hospice professionals see when a new patient is ready for an assessment. Schedulers can go directly to the Schedule Center in Axxess Hospice to schedule an IDG team member for the assessment.
IDG Team Collaboration
Communication is key for empowering compassionate hospice care. Another top CMS survey deficiency is the lack of communication among the IDG team members about the plan of care. Axxess Hospice is built with features that enable clinicians to document the interventions used to address the needs of the patient and either edit or remove them as needed. Hospice aides only have access to document the care that they provide to their assigned patients. The Hospice Aide Plan of Care, developed by the RN Case Manager, is easy for the hospice aide to follow. This helps avoid miscommunication about the care the Hospice Aide should provide.
Clinical notes also have a space to easily document care coordination between the IDG team members and others (the patient, family/caregivers, hospice office staff, etc.). The IDG summary flows to a care log that puts the changes to the Plan of Care at the top of the document, so they are transparent and easily accessed for all members of the assigned team.
The in-house engineers at Axxess have created a hospice software with a foundation from the clinical, operational, and financial expertise of hospice professionals. The intuitive features in Axxess Hospice are built to ensure compliance with a direct way to resolve the top deficiencies identified by CMS surveyors. The other top survey deficiencies for 2018 will be addressed in another blog post. Axxess Hospice is now available to agencies throughout the United States.