About this course
This course teaches hospice aides, nurses, social workers, schedulers, and office staff to recognize and report abuse, neglect, exploitation, and misappropriation of patient property in the hospice setting specifically. Its organizing insight is that hospice is the hardest place in health care to see abuse, because the patient is dying: bruising, weight loss, poor intake, skin breakdown, and withdrawal all have genuine clinical explanations, and those explanations are exactly what allows real harm to be explained away. Part one establishes that problem and reads the governing regulation, 42 CFR 418.52(b)(4), which requires that all alleged violations be reported immediately by hospice employees and contracted staff to the hospice administrator. Part two works through each reportable category using the definitions CMS surveyors actually apply in State Operations Manual Appendix M: physical abuse and injuries of unknown source, verbal abuse, mental abuse, sexual abuse and questions of capacity, financial exploitation and misappropriation of patient property, and drug diversion from the controlled substances hospice places in private homes. Part three covers neglect, including neglect by the hospice itself when a patient waits in unrelieved pain, and the difficult line between self-neglect and a competent patient's right to refuse care. Part four teaches the central discipline of the course: observe, do not diagnose, and report the observation rather than the theory. Part five covers who must report and to whom, including the nursing facility overlay under 42 CFR 418.112(c)(8) and section 1150B of the Social Security Act, and how to write a report that will still be useful six months later. Part six covers what the hospice must do next, the 5 working day clock for reporting verified violations, and the protection staff have against reprisal. Suitable for new-hire orientation, annual mandatory training, and state abuse-reporting training requirements.