General
Inpatient Care
Potential Indicators of GIP
Uncontrolled Pain or pain that requires frequent and/or escalating doses of IV opioids
Respiratory distress
Needs frequent suctioning/trach care
Needs Bipap/requires weaning or titration
Expectation of respiratory distress after withdrawal of respiratory support
High Flow oxygen requirements
Nausea and vomiting requiring IV antiemetics
Severe Delirium/Agitation requiring frequent assessment and management by staff
Seizures requiring frequent monitoring and/or IV medications to control
Seizure prophylaxis with IV medications for patients unable to take medications orally
Complicated wound care requiring frequent or painful wound changes
Other symptoms that cannot be managed effectively in the home or other settings
CMS states that dying, in the absence of significant symptoms, does not qualify as GIP
Documentation Prior to GIP
Severity of symptoms
Effectiveness of (or lack of) current therapies to control symptoms
Amount of prn medications in last 24 hours to control symptoms
If patient not requiring IV medications to control symptoms, why you feel they need GIP
Inability to transport appropriate GIP patients to a dedicated hospice inpatient unit
Vitals unstable
High oxygen requirements
If the patient does not meet above guidelines but is still thought to be appropriate for hospice (e.g., has comorbidities, recent rapid decline), please call for an assessment.
LifeTouch Health now offers Telehealth support for patients and their families in nursing homes, inpatient centers, and their homes.