Hospice Continuous Home Care Crisis Documentation

Documents a hospice continuous home care crisis period, including the clinical trigger, predominantly nursing care provided, time spent, and justification for CHC billing.

Crisis Episode Overview

• Patient Identifier
  Use the medical record number or other internal identifier. Do not enter full SSN or other unnecessary PII.
• Date of Crisis Episode
• Crisis Start Time
• Crisis End Time
  Document the end of the crisis period or nursing coverage window.
• Primary Crisis Trigger
• Brief Crisis Summary
  Describe the acute change, symptoms observed, and why the situation required continuous nursing intervention.

Nursing Care Provided

• Nursing Interventions Provided
• Medications Administered During Crisis
  List only medications relevant to the crisis period and the response observed. Avoid unnecessary detail.
• Patient Response to Nursing Care
  Document whether symptoms improved, remained unstable, or required ongoing intervention.
• Other Disciplines Involved

CHC Billing Justification

• Total Hours of Nursing Care in 24 Hours
  Enter the total nursing care hours provided during the 24-hour period. CHC generally requires at least 8 hours of predominantly nursing care.
• Was the care predominantly nursing care?
  Select Yes only if the documented care was primarily skilled nursing rather than custodial support.
• Does this episode meet the CHC threshold?
  Use this field to indicate whether the documentation supports CHC billing criteria.
• Billing Justification Narrative
  Explain why continuous home care was necessary, including the crisis nature of the episode, the nursing intensity, and the clinical need for continuous presence.

Attestation and Submission

• Documented By
• Role
• Attestation