In this Question of the Week, Tammy Stewart, Clinical Consultant answers a question related to the HOPE A1805 Admitted Form
Q: Several nurses on our team have questions in regard to HOPE A1805 Admitted From and I wanted to provide clarification for them.
It is my understanding that this question is to be answered as to where the patient was at the time of the hospice referral (For example: if the referral was received while the patient is in the hospital for an acute reason, then you would select 04. Short-term General Hospital (acute hospital, IPPS).
The following question has been brought to our attention: “A patient lives in a nursing home that houses both SNF and LTC patients. The hospice patient was in a LTC bed at the time that the referral was placed to hospice. Should the answer to this question be ‘02. Nursing Home (long-term care facility’ or ‘03. Skilled Nursing Facility (SNF, swing beds)’?”
Some clinicians believe that this answer should be “Skilled Nursing Facility” since the facility has both LTC and SNF patients. Another argument is that the answer should be “Nursing Home” since the patient was in a LTC bed at the time of referral to hospice. I tend to lean toward the second argument but would like to get input from HPS.
A: You are correct in that it should be LTC unless the patient was under a skilled level of care in the SNF prior to the hospice election. The HOPE guidance manual actually explains this situation as we’ll explain shortly. The name or type of services a facility provides should not be the basis for the answer selected in the HOPE Admission Assessment. Please let us know if you have any further questions.
Coding Tips:
- If the patient was in multiple settings prior to hospice admission, enter the response that reflects where the patient was at the time of referral to hospice.
- The term “Admitted from” does not necessarily mean that the patient left the facility to be admitted to hospice.
- The location immediately before admission may be the same as immediately after (e.g., a patient may be residing in a long-term care facility and remain there during and after hospice admission)
- Or the two may be different (e.g., a patient may elect hospice while in an acute care hospital and begin receiving hospice services upon returning to their home).
- SNF is not synonymous with nursing facility (e.g., SNF is to be used for patients in a skilled nursing facility, SNF swing bed in a swing bed hospital, or the SNF portion of a dually certified nursing facility).
- If the individual is in a nursing facility but does not meet the criteria above, do not use the response option for SNF; instead, code “02, Nursing Home (long-term care facility).”
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