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Palliative Care Out-Patient Services

Next Reply: Re:Hospital Based Palliative Care/OP visits
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Post Hospital Based Palliative Care/OP visits
Author: Andys46
Date: Nov 15, 2007 7:04 pm
I am coordinating the start-up of a hospital based palliative care consult service. One of my many concerns is what happens when they go home. Does our hospital need a certificate of need to do palliative care home visits? Our local hospice also does palliative care, but they are not staffed to see our patients. I need some ideas and guidance.
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+ Re:Hospital Based Palliative Care/OP visits (by eyellig on 11/16/2007)
Our palliative care program has been set up to do home consults and care. Many of our home patients are ones that we have seen in the hospital. We have 1.5 FTE NP's and myself doing these consults. You would need an order from the patient's MD to go and see this patient in order to bill for the consultation. You do not need a CON to do this. Feel free to call me if you would like to talk about other ideas or get answers to more questions. 919-828-1998.
Re:Hospital Based Palliative Care/OP visits (by txcuyegkeng on 12/20/2007)
Andy: The post-acute care piece can be handled through an order for HOME HEALTH NURSING follow-up using their Medicare or Home Health benefit. Physician home visits of course a reimburseable from Medicare and do not require a separate certificate or license. In my setting, we also have TELEPHONIC nurse coordination to make sure that the patient receives the services we ordered as part of the consultation and to close the loop with the Home-based providers. You can of course also see them in Palliative medicine clinic -- you may find that the availability of clinic permits you to more safely discharge your patients and address unresolved issues following the hospitalization.
Re:Hospital Based Palliative Care/OP visits (by tcousounis on 02/24/2008)
Andy, there are numerous models (too many to discuss in detail here but I'm happy to share them off-line, tcousounis@digital-action.com) of delivering palliative care in a continuum. The greatest challenge you'll likely encounter is assessing the pros and cons of these models in light of the program's objectives, and its milestone metrics, and selecting the right model. Defining these milestone metrics is a formidable, but absolutely essential, step in developing a palliative care consult service. Tim Cousounis, MDvantage Palliative Care Group

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