{"ref":"OH-HSP-ADM-01","title":"Referral, Eligibility, Admission and Veterans Benefits Notice","category":"Hospice care","summary":"Sets out how the Agency receives referrals, decides whether a person is eligible for hospice care under Ohio and federal rules, completes the admission visit in the required order, gives the Ohio veterans benefits notice, meets the Ohio Medicaid conditions that must be in place before care, and responds when it cannot admit.","inShort":["Record every referral on the referral form the day it comes in, and contact the family and physician by the next business day.","We admit only people who are terminally ill, choose hospice and are recommended by an Agency physician.","At the admission visit, give rights, consent, election, advance directive and opioid policy information before any care.","Ask every patient whether they or their spouse served in the military, and give the veterans benefits notice.","If we cannot admit someone, tell them and the referral source why, and suggest other help."],"primaryCitation":"OAC 3701-19-20(A)","citations":["OAC 3701-19-20(A)","OAC 3701-19-20(B)","OAC 3701-19-20(F)","OAC 3701-19-01","ORC 3712.01(B)","ORC 3712.06(I)","ORC 3712.062(B)(1)-(2), (7)","OAC 3701-19-10(B)(2)","OAC 3701-19-11(D)(1)-(2)","OAC 5160-56-02(A)-(G)","OAC 5160-56-04(G), (K)","ORC 5901.01"],"federalCitations":["42 CFR §418.20","42 CFR §418.25","42 CFR §418.22","42 CFR §418.3","42 CFR §418.52(a)","42 CFR §418.54(a)","42 U.S.C. §1396d(o)(1)(C)"],"surveyorAsks":["Walk me through what happens from the moment you receive a referral to the first hospice visit.","Who recommends admission, and where is the physician's review of eligibility documented?"],"forms":[{"ref":"OH-HSP-ADM-01-A","title":"Referral and Eligibility Screening Record"},{"ref":"OH-HSP-ADM-01-B","title":"Veterans Benefits Information Notice"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (OAC 3701-19-20(A)-(B); ORC 3712.06(I))","5. Eligibility Criteria","6. Receiving a Referral","7. Physician Review and Admission Decision","8. The Admission Visit","9. Veterans Benefits Notice (ORC 3712.06(I))","10. Ohio Medicaid Admissions","11. When the Agency Does Not Admit","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"oh-hospice","state":"Ohio","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}