The Center for Medicare and Medicaid Services (CMS) Medicare Learning Network (MLN) has published a Fact Sheet on Creating an Effective Hospice Plan of Care.
All hospice care and services offered to hospice patients and their families must follow an individualized written plan of care. The Plan of Care should reflect patient and family goals and interventions based on the problems identified in the assessments. This fact sheet identifies the principles of care planning and the role of the interdisciplinary group and RN coordinator.
