Medical Director Responsibilities
- Lead Interdisciplinary team (IDT) (Bimonthly meeting to develop a patient and family-centered plan of care)
- Document clinical disease progression to initiate, maintain, or recommend discontinuing hospice services
- Timely documentation (IDT notes, F2F, CTI, order signatures & timesheets)
- F2F Point Care Training Video
- Face-to-Face Recertification Encounter Timesheet
- MD Timesheet
- IDT Time Template (Discussion 5-6 min. for new admit, 2-3 min for recerts and recurring, Census of 40 patients to take 2-3 hours)
- Determining Medication Necessity
- All medications are reviewed at admission by the admitting RN with the hospice physician
- Determination is based on the physician
- Medications are considered regarding relatedness and covered and in each case are based on the unique circumstances of the patient.
- Entresto: related but not covered -have a therapeutic interchange
- Cardiac meds in cancer – depends on whether the cardiac condition is impacting prognosis. If stable cardiac wise unrelated; if symptomatic, oxygen dependent, etc. -related.
- There are four classes of medications that are always provided:
- Analgesics
- Anxiolytics
- Antiemetics
- Laxatives/stool softeners
- Activate & utilize Compassus email/Microsoft Teams
- Promptly respond to messages and calls (urgent requests within the hour)
- Timely face-to-face completion
- Participate in quarterly medical director meeting
- Notify DCS when taking time off and coordinate coverage
- Death certificate completion
- Establish and maintain accreditation Hospice Medical Director Certification
- Medical Directors Roles and Responsibilities
- Participate in QAPI (Quality assessment Performance Improvement)
Interdisciplinary Team Meeting (IDT)
- Review patient clinicals prior to IDT to discuss patient care plan and complete CTIs
- IDT Agenda and Sign-in
- CTI Physician Tip Sheet
- CTI Examples(PDF, 65 KB)
- De-prescribing Recommendations
- Optum formulary
- Enclara formulary
- One-point formulary
- Document subjective & objective data to demonstrate the progression of illness
- Recommend discontinuation of hospice services if ineligible with the transition to palliative care
- Cloning notes is strictly prohibited
- Avoid the use of signs or symptoms as a hospice diagnosis (FTT or debility)