Changes in hospice and HVLDL standard which are the hospice visits in the last days of life. This requires an RN or MSW to be present in the home 2 out of the 3 last days of life. This is a new process implemented by CMS to ensure that the clients are cared for during a very vulnerable time in their hospice experience.

During this time there are often medication changes needed for symptom management and the biggest goal of care at times is letting the family know we are here for their support. The national average is 75% and Alpha currently is sitting at 83%. Topics that fall under this include RN assessments to recognize signs of an actively dying patient and education coverage for family, how to speak with them, how to educate them about the death and dying process to ease the fear.