Nurses/Nurse Practitioners

Within the Medicare Hospice Benefit, Nurse Practitioners (NPs) can serve as a patient’s chosen attending physician when selected by the patient.  Nurse Practitioners may also complete a hospice face-to-face encounter.  NPs may not:

1. Certify or recertify a patient’s terminal illness;
2. Represent or replace the hospice medical director or physician designee in the IDG; or
3. Bill services to Medicare unless they are the chosen attending physician of the patient.

NHPCO Member Resources

• Nurse Practitioners as Attending Physicians in the Medicare Hospice Benefit  September 24, 2004
• Nurse Practitioner Services Under Medicare Hospice June 20, 2003

Physicians

Hospice physicians may be directly employed or contracted by the hospice provider.  They may also be a volunteer.

NHPCO Member Resources

• Hospitalists and Hospices:  Opportunities for Collaboration October 2003
• Physician Care Plan Oversight 1995

Staffing

NHPCO Member Resources

• Classification of Social Workers for the Purpose of Workers’ Compensation
• Staffing Guidelines
  • NHPCO no longer suggests specific staffing caseloads for an IDG member because of the vast variability that can affect a caseload.  The Staffing Guidelines for Hospice Home Care Teams is based on the recognition of the current diverse nature of hospice care and allows for individualization of staffing caseloads according to the organizational and environmental characteristics specific to each hospice, in much the same way hospices individualize patient care.