Overview

HospiceWorks can automatically generate a Prognosis Documentation Summary (Automated Prognosis Summary) inside the Rationale field using discrete clinical data captured in the Hospice Criteria Review and transferred into the Initial Nursing Assessment (INA). The narrative is only generated when the RN confirms the patient meets hospice criteria, and it remains fully editable. If authorized, the finalized narrative can flow into the current CTI documentation for physician review.

What this feature does

When triggered, HospiceWorks compiles a structured narrative from documented fields to support hospice eligibility/prognosis documentation. The goal is to reduce manual narrative writing, improve consistency, and keep documentation survey-ready while still allowing clinician edits.

Where to find it

You’ll see this automation in the eligibility/assessment workflow:

  • Hospice Criteria Review (data captured here)

  • Initial Nursing Assessment (INA) → Rationale field (narrative generates here)

When it generates (the trigger)

The Rationale box stays empty until the RN selects “Yes” to:

Patient meets Hospice Criteria?

Once “Yes” is selected, HospiceWorks generates the narrative and populates the Rationale field.

What data it uses (inputs)

The summary pulls from charted data captured in Hospice Criteria Review and transferred into the INA, including:

  • Terminal Diagnosis (primary ICD-10 + description)

  • Related Diagnoses (table entries)

  • Comorbidities (table entries)

  • Functional Scores: FAST, PPSv2, ECOG

  • Recent Clinical Decline Indicators (checked items)

  • Disease-Specific LCD Indicators (checked items)

What the narrative includes (high-level)

The system compiles the data into a single prognosis narrative that typically reflects:

  • Primary terminal condition

  • Relevant comorbidities/related conditions (when present)

  • Functional status/severity using scores (FAST/PPS/ECOG)

  • Recent decline indicators and disease-specific criteria

  • A prognosis statement consistent with hospice eligibility documentation expectations

Clean output (no awkward blanks)

If optional sections like Related Diagnoses and/or Comorbidities are empty, HospiceWorks omits those sentence fragments so the narrative reads cleanly.

Can clinicians edit it?

Yes. The Rationale field remains a standard editable text area. Nurses can refine wording, add specifics, or adjust phrasing before saving.

How it flows into the CTI (physician documentation)

After the summary is generated, HospiceWorks presents the authorization question:

Should the contents of this rationale flow to the Current Certification’s Documentation Prognosis Summary?

  • If Yes: when the INA is saved, the finalized Rationale text flows into the CTI narrative/prognosis summary area for physician review.

  • If No: the narrative stays in the INA and does not populate the CTI.

Best practices (keep it simple)

  • Enter key charting data before selecting “Patient meets Hospice Criteria = Yes” (diagnoses, scores, decline/LCD indicators).

  • After generation, do a quick read-through and edit as needed to reflect the patient’s current clinical picture.

  • Only allow the narrative to flow to CTI when it’s ready for physician review.

FAQ

1. Does this replace clinical judgment?
No. It drafts a narrative from your documented data. Clinicians review/edit, and the physician still reviews the CTI narrative.


2. Why is my Rationale blank?
Because the narrative only generates after selecting “Yes” for Patient meets Hospice Criteria.


3. Can I stop it from going to CTI?
Yes. Select No on the authorization question so it remains in the INA only.