This customizable document, Patient Non-Certification, is taken from MCN Healthcare’s Hospice Policy and Procedure Manual. For more than 20 years, MCN has been the health care industry’s leading provider of policy and procedure templates, forms, competencies and other compliance tools.

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 Patient Non-Certification:

	PURPOSE: To delineate the process to follow when a patient no longer meets requirements for a time-limited prognosis. POLICY: If the physician and the Hospice Medical Director determine a patient receiving Hospice service does not meet the time-limited prognosis usually less than six 6] months that individual will need to defer Hospice benefits. PROCEDURE: The physician will sign the Patient Non-Certification form. Hospice files the Patient Non-Certification form in the medical record. 1 SUBJECT:PATIENT NON-CERTIFICATIONREFERENCE #2006PAGE: 1DEPARTMENT: HOSPICE OF: 1EFFECTIVE: ...
Second excerpt:
	...sign the Patient Non-Certification form. Hospice files the Patient Non-Certification form in the medical record. 1 SUBJECT:PATIENT NON-CERTIFICATIONREFERENCE #2006PAGE: 1DEPARTMENT: HOSPICE OF: 1EFFECTIVE: APPROVED BY: REVISED: ...