As the health care industry’s most comprehensive library of customizable policy and procedure templates, MCN Healthcare’s Hospice Policy and Procedure Manual includes this customizable template, Hospice Admission Assessment Form. MCN’s policy library helps you meet compliance with Joint Commission and federal regulations including CMS, CDC, OSHA, OIG, HIPAA and more.

MCN provides more than 80 health care specific policy and procedure manuals for Acute Care Hospitals, Ambulatory Care, Behavioral Health, Home Health, Physician Practice, and Long Term Care. MCN’s policy and procedure manuals focus on the latest healthcare "hot topic" issues related to patient safety and prevention of medical healthcare errors.

Here is some sample content from Hospice Admission Assessment Form:

	HOSPICE ADMISSION ASSESSMENT Patient Name: Address: Admission Date: Diagnosis: Patient's Concept of Reason for and Response to Hospice Care: Advance Directives: Emergency Contacts: Name: Name: Name: Power of Attorney/Healthcare Surrogate: Name: Vital Statistics: Height: Pulse: Current Medication: see also Medication Reconciliation/Verification FormOTC Medication:Name Allergies/Describe Allergic Reaction: Food: Drugs: Other: Smoker: Major Illnesses, Surgeries and Hospitalizations include dates, hospitals, agencies: Assessment of Pain assess each pain: Have patient describe...
Second excerpt:
	...meds:Origin: Non-Verbal Patient Exhibiting Symptom of Pain: Laboratory Results: TB Screening: IV Therapy: Peripheral Line: Central Line: Venous Access Devices: REVIEW OF SYSTEMS Check all appropriate items 1. No problems Glasses Blurring Headaches Diplopia Inflammation Cataracts Glaucoma Puffy lids Jaundice sclera Comments: 2. No problems Limited Hearing Aid Pain Ringing Discharge Feeling of Fullness Comments: 3. Clear Slurred Non-English speaking Can understand Can express ...