Inpatient Care Arrangements for Symptom Management and Respite
Sets out how the Agency arranges short-term inpatient care for pain and symptom management and for respite when it does not provide that care in its own facility: only in a licensed hospital, nursing facility or hospice inpatient facility that meets the federal standards, under a written agreement signed by both providers with every provision North Carolina and 42 CFR §418.108(c) require, with the monthly updated plan of care sent to the facility, hospice professional management throughout the stay, the discharge summary kept in the hospice record, and the Medicare five-day respite and 20 percent inpatient limits monitored.
- Policy number
- NC-HSP-FAC-02
- Version
- 1.0
- Main rule
- 10A NCAC 13K .0501(5)
- Library
- North Carolina hospice · 60 policies
- Category
- Hospice care
- Sections
- 21
In short
- Use only inpatient facilities that have a signed agreement with the Agency: Sample General Hospital and Sample Nursing and Rehabilitation Center.
- Send the current plan of care, orders, medication list and advance directives with the patient.
- During a general inpatient stay, a hospice nurse visits or calls the facility every day and checks whether inpatient care is still needed.
- Get the facility's discharge summary and file it in the hospice record.
- Plan the return home with the family so care continues smoothly. Medicare respite is limited to five days at a time.
What's inside
21 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (10A NCAC 13K .0501(5))
- 5. Where Inpatient Care May Be Given
- 6. The Written Agreement
- 6.1 Additional terms
- 7. Arranging an Admission
- 8. During the Stay
- 9. Training of Facility Staff
- 10. Discharge From the Inpatient Stay
- 11. Limits the Agency Monitors (if Medicare-certified)
- 12. Checking That Agreements Work
- 13. Responsibilities
- 14. Records and Compliance Monitoring
- 15. Staff Training
- 16. References
- 17. Related Policies and Forms
- 18. Approval
- 19. Revision History
An inspector may ask
- Which facilities do you use for general inpatient care and respite? Show me the agreements.
- How do you make sure the facility follows your plan of care? What did you send for this patient?
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