Hospice Physician Orders Tracking

The attending physician is the doctor the patient and family designate as their primary care provider. The hospice medical director is the certifying physician employed or contracted by the hospice agency. Under 42 CFR 418.22, both physicians sign the initial certification of terminal illness. After admission, either physician can write orders, but the attending physician usually leads day-to-day medical decisions while the hospice medical director oversees clinical eligibility, recertification, and complex symptom management. Our team routes each order to the correct signing physician and reconciles conflicts before the order reaches the chart.

A verbal order is captured by a licensed clinician (typically an RN) during a phone call with the ordering physician. The clinician repeats the order back word-for-word, the physician confirms, and the clinician documents the readback with date, time, and both names. Per 42 CFR 418.64, the ordering physician must countersign the verbal order within the regulatory signature window (commonly 48 hours, but state rules may vary). Our hospice orders specialists log the verbal order immediately, track the signature deadline, and send the order to the physician for countersignature with full readback documentation attached.

Schedule II controlled substances (morphine, fentanyl, methadone, hydromorphone) require strict DEA tracking. Our team verifies the prescribing physician's DEA registration is active and valid for the state of practice. Every Schedule II order is logged with quantity, dispensing pharmacy, refill restrictions, and patient-specific documentation. After a patient death, we coordinate the controlled substance disposal documentation per DEA guidelines and the hospice agency policy, including witness signatures where required.

E-signatures inside HCHB, MatrixCare Hospice, Suncoast, WellSky Hospice, KanTime Hospice, and Netsmart are authenticated by the platform and tied to a unique user ID with a complete audit trail. Our specialists verify that each e-signature is captured within the 42 CFR 418.64 signature window, that the audit trail captures user, date, time, and IP origin, and that the signature aligns with 21 CFR Part 11 electronic record standards. Orphan orders without a valid e-signature are flagged daily.

Routine orders (medications, treatments, durable medical equipment) typically carry expiration dates that align with the benefit period or the order's clinical reason. Our team tracks expiring orders at 7, 14, and 30 days before lapse. Renewal requests are routed to the attending physician or the hospice medical director with full clinical context (current symptoms, recent assessment, medication response). This prevents lapsed orders that interrupt symptom management or pharmacy refill processing.

Every order captured, routed, signed, and renewed is logged in chronological order with full metadata: physician name, signature method, date, time, clinical reason, and any conflict reconciliation notes. We can pull a complete order log per patient in under 5 minutes for a CMS survey, state survey, ADR response, or accreditation site visit. Hospice CoP deficiencies (the hospice equivalent of nursing home F-Tags) are tagged proactively so leadership can correct gaps in advance.

Per-FTE weekly pricing. $399 per week per FTE for a standard single-site hospice agency. $349 per week per FTE for the popular volume tier (3 or more FTEs across orders, IDG, and intake). $299 per week per FTE for an enterprise hospice network with 10 or more FTEs. No setup fees. No annual contracts. Add or remove FTEs by the week.

You get 14 days of live hospice orders work at the same per-FTE weekly rate. We capture verbal orders, route for signature, track the 48-hour rule, audit controlled substance logs, and report daily. At the end of day 14 you decide go or no-go. Cancel before day 14, owe nothing. No annual contract after.