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03/17/2026

Leaders: on call log

Tips for Hospice Leaders:

If you’re a hospice leader, the very first thing you should review every morning is your on-call log.

Your on-call log is more than a list of overnight calls. It is a diagnostic test of how your hospice agency is actually functioning. When you review it closely, it can reveal breakdowns in processes, operational gaps, or clinicians who may need additional support.

Here are three things every hospice leader should look for:

1. Was a visit provided? There is a growing trend toward triaging calls over the phone and avoiding visits. But families usually call because they are scared, not because they simply need a question answered. In many cases, what they truly need is the reassurance of a nurse at the bedside.

2. What was the reason for the call?Look closely at why the call occurred. Was it something that should have been addressed during the day? These patterns often highlight process gaps, communication issues, or missed opportunities for proactive care.

3. Follow up the next morning.
Every single patient or caregiver who called overnight should receive a follow-up call the next day. This can be done by you or delegated to a member of the team. A quick call to ensure their needs were met and that they are doing well today builds trust and strengthens the hospice experience.

When leaders consistently review the on-call log and act on what it reveals, agencies see fewer live discharges, stronger quality scores, and higher patient and family satisfaction.

All three directly protect the financial health of your hospice.

At The Amity Group, we are dedicated to Advancing the Art of Hospice Care by supporting hospice agencies through specialized hospice staffing, audit and ADR support, education and training, hospice documentation resources, and innovative tools designed specifically for hospice clinicians.

AmityStaffing.com
Hospice is all we do.

03/17/2026

Tips for Hospice Leaders:

If you’re a hospice leader, the very first thing you should review every morning is your on-call log.

Your on-call log is more than a list of overnight calls. It is a diagnostic test of how your hospice agency is actually functioning. When you review it closely, it can reveal breakdowns in processes, operational gaps, or clinicians who may need additional support.

Here are three things every hospice leader should look for:

1. Was a visit provided? There is a growing trend toward triaging calls over the phone and avoiding visits. But families usually call because they are scared, not because they simply need a question answered. In many cases, what they truly need is the reassurance of a nurse at the bedside.

2. What was the reason for the call?Look closely at why the call occurred. Was it something that should have been addressed during the day? These patterns often highlight process gaps, communication issues, or missed opportunities for proactive care.

3. Follow up the next morning.
Every single patient or caregiver who called overnight should receive a follow-up call the next day. This can be done by you or delegated to a member of the team. A quick call to ensure their needs were met and that they are doing well today builds trust and strengthens the hospice experience.

When leaders consistently review the on-call log and act on what it reveals, agencies see fewer live discharges, stronger quality scores, and higher patient and family satisfaction.

All three directly protect the financial health of your hospice.

At The Amity Group, we are dedicated to Advancing the Art of Hospice Care by supporting hospice agencies through specialized hospice staffing, audit and ADR support, education and training, hospice documentation resources, and innovative tools designed specifically for hospice clinicians.

AmityStaffing.com
Hospice is all we do.

03/16/2026

Tips for Hospice Leaders: considering patient acuity when determining caseloads is crucial to ensuring all the patient’s needs are met.

Acuity is simply determining how much time each patient requires and providing each nurse enough time to meet all the patient and caregiver needs.

In hospice we have 3 areas of Acuity to consider:

1. Physical Acuity: This refers to the patient’s physical condition and needs (wounds, drains, ostomies, etc).

2. Geographical Acuity: how long it takes to get to the patient (distance, terrain, traffic, parking, etc).

3. Emotional Acuity: This focuses on the patient and caregiver’s emotional well-being, coping mechanisms, and support system, etc.

By taking into account these different types of acuity when setting caseloads, hospice agencies can actually save money in several ways:

1. Prevents burnout and expensive turnover in staff.
2. Decreases after-hour calls.
3. Increases patient satisfaction and quality scores.
4. Decreases live discharges.
5. Protects reimbursement because nurses have enough time to focus on documenting to support eligibility.

I’m happy to give you the acuity tool I developed, visit my website and leave a request and we can set up a time to meet via Zoom and I’ll show how to use the tool: www.AmityStaffing.com

Grow your census with confidence … partner with Amity!
www.AmityStaffing.com

amity theamitygroup hospiceacuity
hospicecare leader caseloads acuity staffing patientacuity QualityCare StaffRetention PatientSatisfaction endoflifecare

03/16/2026

Tips for Hospice Leaders: considering patient acuity when determining caseloads is crucial to ensuring all the patient’s needs are met.

Acuity is simply determining how much time each patient requires and providing each nurse enough time to meet all the patient and caregiver needs.

In hospice we have 3 areas of Acuity to consider:

1. Physical Acuity: This refers to the patient's physical condition and needs (wounds, drains, ostomies, etc).

2. Geographical Acuity: how long it takes to get to the patient (distance, terrain, traffic, parking, etc).

3. Emotional Acuity: This focuses on the patient and caregiver’s emotional well-being, coping mechanisms, and support system, etc.

By taking into account these different types of acuity when setting caseloads, hospice agencies can actually save money in several ways:

1. Prevents burnout and expensive turnover in staff.
2. Decreases after-hour calls.
3. Increases patient satisfaction and quality scores.
4. Decreases live discharges.
5. Protects reimbursement because nurses have enough time to focus on documenting to support eligibility.

I’m happy to give you the acuity tool I developed, visit my website and leave a request and we can set up a time to meet via Zoom and I’ll show how to use the tool: www.AmityStaffing.com

Grow your census with confidence … partner with Amity!
www.AmityStaffing.com

03/14/2026

Tip for Hospice Nurses: Today I’m sharing self-care tips to help make the job part of hospice nursing a little more manageable.

Here are 3 things that I personally do to make my workday a little bit better:

1️⃣ Before leaving a patient’s home, I take a few minutes the most tedious, and my least favorite sections of the note. This way, I only have 15 minutes of pretty easy documentation (per patient) to do when I get home at night

2️⃣ I have a separate work phone that I turn completely off 📵and put in my TagBag when I’m not working. This helps me to disconnect from work and focus on my personal life, which is essential for maintaining a healthy work-life balance.

3️⃣ While driving from pt to pt, I make a conscious effort to look for beautiful, weird, and wonderful things in the environment. This helps me to be more present and mindful, and it makes my drive more pleasant. 🕊️

Remember, taking care of ourselves is just as important as taking care of our patients. Let’s prioritize our mental health and wellness 🧘‍♀️so that we can live our best life 🥰.

findyourjoy selfcare hospicenurse worklifebalance mentalhealth wellness mindfulness love your life

03/14/2026

Tip for Hospice Nurses: Today I’m sharing self-care tips to help make the job part of hospice nursing a little more manageable.

Here are 3 things that I personally do to make my workday a little bit better:

1️⃣ Before leaving a patient's home, I take a few minutes the most tedious, and my least favorite sections of the note. This way, I only have 15 minutes of pretty easy documentation (per patient) to do when I get home at night

2️⃣ I have a separate work phone that I turn completely off 📵and put in my TagBag when I'm not working. This helps me to disconnect from work and focus on my personal life, which is essential for maintaining a healthy work-life balance.

3️⃣ While driving from pt to pt, I make a conscious effort to look for beautiful, weird, and wonderful things in the environment. This helps me to be more present and mindful, and it makes my drive more pleasant. 🕊️

Remember, taking care of ourselves is just as important as taking care of our patients. Let's prioritize our mental health and wellness 🧘‍♀️so that we can live our best life 🥰.

03/13/2026

Tip for Hospice Nurses: We have to be so diligent to support hospice eligibility for patients with Alzheimer’s or dementia, because the records are highly scrutinized.

One area that we want to pay attention to is orientation. Commonly I will see “pt oriented x1”.

First of all, remember to flip that to the negative by stating “pt disoriented x3”.

Also, most of the dementia pts on hospice are not really oriented to self - to determine this the pt must be able to independently tell you their name, the name of their caregiver or someone close to them. Just responding when someone speaks their name does not mean they are oriented to self.

Here are some other key points to keep in mind when documenting on a pt with dementia:

1️⃣ Use PAINAD or FLACC score to measure pain. Patients with primary dementia diagnosis cannot provide a numeric pain score.

2️⃣ Patients should always require maximum, if not total, assistance with feeding.

3️⃣ Patients should not be able to effectively express thoughts or feelings.

You can find more documentation tips in the Hospice Documentation Guides on my website: www.amitystaffing.com, or for even more support get DAHN, the Documentation App for Hospice Nurses on your App Store, or at www.getDAHN.com

Ya’ll be safe out there! I love you guys … xoxo ~ Shelley 💕

amitynurse amity hospice hospicenurse alzheimer alzheimers hospiceeligibility hospicedocumentation charting chartingtips assessment palliative mood affect affectassessment dementia

03/13/2026

Tip for Hospice Nurses: We have to be so diligent to support hospice eligibility for patients with Alzheimer's or dementia, because the records are highly scrutinized.

One area that we want to pay attention to is orientation. Commonly I will see “pt oriented x1”.

First of all, remember to flip that to the negative by stating “pt disoriented x3”.

Also, most of the dementia pts on hospice are not really oriented to self - to determine this the pt must be able to independently tell you their name, the name of their caregiver or someone close to them. Just responding when someone speaks their name does not mean they are oriented to self.

Here are some other key points to keep in mind when documenting on a pt with dementia:

1️⃣ Use PAINAD or FLACC score to measure pain. Patients with primary dementia diagnosis cannot provide a numeric pain score.

2️⃣ Patients should always require maximum, if not total, assistance with feeding.

3️⃣ Patients should not be able to effectively express thoughts or feelings.

You can find more documentation tips in the Hospice Documentation Guides on my website: www.amitystaffing.com, or for even more support get DAHN, the Documentation App for Hospice Nurses on your App Store, or at www.getDAHN.com

Ya’ll be safe out there! I love you guys … xoxo ~ Shelley 💕

03/11/2026

TIPS FOR HOSPICE NURSES: Understanding the difference between terminal agitation and general agitation.

I’ve been getting a lot of questions about this, and it’s important because the approach to treatment is very different.

Terminal agitation occurs at the very end of life when Patient is already bedbound, withdrawn, not eating, barely drinking, and no longer interacting. Then agitation suddenly appears. In these situations, we treat aggressively and quickly because our goal is to restore comfort before the end of life so Patient can have a peaceful d*ath.

General agitation can happen at any point during hospice, and we see it frequently in dementia. Patient may still be eating, interacting, and somewhat alert, but can go through a period of significant agitation that may last weeks. In these cases, treatment is usually carefully titrated so agitation improves while Patient can remain as alert and comfortable as possible. As symptoms improve, medications are gradually reduced.

There are many ways clinicians approach agitation depending on region, physician practice patterns, agency policies, and experience levels. The key is reassessing frequently and adjusting the plan until you find what works best for Patient.

The goal of hospice is always comfort and dignity at the end of life. A peaceful d*ath matters for Patient and for the family who will carry that memory forward.

For more hospice tips and resources, visit
www.AmityStaffing.com

Shelley Henry, RN
Founder, The Amity Group
Advancing the Art of Hospice Care

03/10/2026

Hospice audits are no longer rare. They are routine. The agencies that navigate them successfully are the ones that prepared before the audit letter arrived.

That’s exactly why we built the Amity Audit Division.

Our auditors are not retired reviewers who worked in hospice decades ago. Every Amity auditor is a current hospice field clinician, actively working in today’s regulatory and documentation environment. We understand what documentation actually looks like in the field right now, and that matters, because we do not simply identify problems. We build practical solutions that fit how your clinical team already works. We help implement those solutions, monitor whether they are effective, and refine them until they integrate seamlessly into your agency’s workflow.

Our goal is not to change the way your team practices hospice.
Our goal is to strengthen the documentation that supports the care they are already providing.

Amity works alongside hospice agencies across the country, staying on top of current audit trends and regulatory expectations so our clients remain ahead of the curve. And when audits do occur, we do not disappear. We stand beside our clients through the entire process, including appeals through ALJ hearings when necessary.

Preparing for an audit is not just about compliance. It is about protecting your organization, your clinicians, and your bottom line.

At Amity, we are committed to
Advancing the Business of Hospice.

03/10/2026

Tip for Hospice Nurses: I get a lot of questions about how to know when a patient is in the pre-transitional phase and what things are important for the hospice nurse to consider during this phase.

During this video I discuss some areas to consider, but there are many, so please add your thoughts and experiences.

Ya’ll be safe out there!
Xoxo ~ Shelley 💕

hospicenurse hospice endoflife transitioning phases peace peaceful support fyp nurse nurses

The Amity Group

03/17/2026

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03/10/2026

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