The Physician Narrative

The Physician Narrative 

This course will discuss the physician narrative. It will review the importance of physician documentation for hospice certification and re-certification, as well as how clear, concise documentation of hospice eligibility can lead to improved care. As you go through this course, you will learn of hospice certification and recertification requirements as the context for the physician narrative. You will also be able to describe the physician narrative regulatory requirements. In addition, you will review strategies the physician may use to better compose certification and recertification narratives. This module is written for the entire interdisciplinary group, with an emphasis on hospice physicians.

$15.00

Hours: 1.00
REL-HOS-0-TPN-V2

Certificates

Certificates provided by accrediting body (8 Match)

California Board of Registered Nursing

1.0 HOURS


Provider approved by the California Board of Registered Nursing, CEP# 13791

Nurses will receive 1.00 contact hours for participating in this course.

American Nurses Credentialing Center

1.0 HOURS


Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 1.00 contact hours for participating in this course.

District of Columbia Board of Nursing

1.0 HOURS


DC-RN -- District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290).

Nurses will receive 1.00 contact hours for participating in this course.

Florida Board of Nursing

1.0 HOURS


Florida Board of Nursing CE Provider #: 50-290

Nurses will receive 1.00 contact hours for participating in this course.

Georgia Board of Nursing

1.0 HOURS


Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 1.00 contact hours for participating in this course.

South Carolina Board of Nursing

1.0 HOURS


This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-[Custom_Code]

West Virginia Board of Registered Nursing

1.0 HOURS


New Mexico Board of Nursing

1.0 HOURS


New Mexico Board of Nursing (CEBroker Provider # 50-290)

This course awards 1.00 contact hours upon successful completion.

Course Details

Course Code: REL-HOS-0-TPN-V2
Hours: 1
Type: Online Course
Content Expiration Date: 6/30/2021
Learning Objectives:
Explain the hospice certification and recertification requirements as the context for the physician narrative.
Describe the physician narrative regulatory requirements.
Identify the components effective certification and recertification narratives.

Outline:
Section 1: Introduction

About This Course

Learning Objectives

Section 2: The Certification & Recertification of Terminal Illness

The Initial Certification and Recertification of Terminal Illness

The Face-to-Face Encounter

Who Performs the Face-to-Face Encounter?

Exceptions to the Face-to-Face Encounter Requirement

Time Frames for Certifications and Recertifications

Certification and Recertification Content

Additional Certification and Recertification Content

Review

Summary

Section 3: Regulatory Requirements

The Origin of the Physician Narrative

Introduction to the Regulatory Requirements

The Attestation and the Narrative

Signatures

The Narrative Summary Statement

Narrative Format

Elements of an Optimal Narrative: Elements 1-2

Elements of an Optimal Narrative: Elements 3-9

Review

Summary

Section 4: Initial Certification Narratives

Clinical Scenario Examples

Initial Certification Narrative: The Certain Certification, Example 1

Initial Certification Narrative: The Certain Certification, Example 2

Initial Certification Narrative: The Certain Certification Example 2 Continued

Initial Certification Narrative: Eligibility Supported by Medical Records, Example 1

Initial Certification Narrative: Eligibility Supported by Medical Records Example 1

Initial Certification Narrative: Eligibility Supported by Medical Records, Example 2

A Note about the Eligibility Supported by Medical Records, Example 2

A Note about Dementia and Eligibility Codes

Initial Certification Narrative: No Medical Records Available

Initial Certification Narrative: No Medical Records Available, Example 1

No Medical Records Available, Example 1 Narrative

A Note About Debility and Adult Failure to Thrive

Initial Certification Narrative: No Medical Records Available, Example 2

Review

Summary

Section 5: Recertification Narratives & Narratives for the Deceased

Recertification into the Advanced Benefit Period: Clearly Eligible, Example 1

Clearly Eligible Example 1 Recertification Narrative, Continued

Clearly Eligible Example 1 Recertification Narrative, Continued

Recertification into the Advanced Benefit Period: Clearly Eligible, Example 2

Clearly Eligible Example 2 Factors to Consider

Recertification into the Advanced Benefit Period: Slow Decline Example

Slow Decline Example Factors to Consider

Slow Decline Example In-Depth Analysis

Person is Deceased at the Time the Physician Writes the Narrative

Person is Deceased at the Time the Physician Writes the Narrative Example

Review

Summary

Section 6: Conclusion

Summary

Course Contributors

Resources

References

Congratulations!

Expert Reviewer: Aletha W. Tippett, BSChE, MD, ABFP, ABHPM, AAPM, WCC, CWS
Dr. Aletha Tippett received her BS in chemical engineering from the University of Missouri in 1975 and her MD from the University of Cincinnati in 1997. Dr. Tippett has done wound care for 20 years and has treated over 15,000 wounds. Her main areas of focus in wound care are limb salvage and pressure ulcer prevention and treatment and she brings a bio-engineering approach to these. She has been honored with numerous awards in the healthcare community and is a published author and international speaker and teacher on wound care topics. She is president of the Hope of Healing Foundation, dedicated to limb salvage and novel wound therapies. She is a member of the International Biotherapy Society and is an active "biotherapist", using maggots and leeches in her wound care practice. Dr. Tippett is also active in hospice and is a certified hospice medical director for Brookdale Hospice in Dayton, Ohio. Disclosure: Aletha W. Tippett, BSChE, MD, ABFP, ABHPM, AAPM, WCC, CWS has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Staff Writer: Susan Heinzerling, RN, CHPN
Susan Heinzerling began her nursing career as a Med/Surg nurse. Renal patients in acute care, with multiple chronic conditions and repeated hospitalizations inspired her practice of hospice nursing where she began as Hospice Admissions Nurse and later became a Hospice RN Case Manager. Susan has practiced hospice nursing in both a large, urban area and in a rural setting. Susan earned a B.S. in Biology and B.S. in Nursing from the University of North Carolina at Chapel Hill and a Master's degree in Physiology from North Carolina State University. She became a Ph.D. Candidate in Immunology at the University of South Alabama. Her research experiences in the biomedical sciences led to an interest in evidence-based practices. Disclosure: Susan Heinzerling, RN, CHPN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: Nurses; Physician Assistants; Physicians; in the following settings: Hospice, Palliative Care.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Accommodations
If you require special accommodations to complete this module, please contact Relias Customer Support here.