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The Amity Group, 210 Magnate Drive, Suite 201, Lafayette, LA (2025)

11/14/2025

Tips for Hospice Nurses:
I was contacted by a nurse who was worried she’d lose her hospital skills by becoming a hospice nurse. I get it, but we know that it’s actually the opposite. Hospice nursing requires skills you never even knew you had.

The top three skills you’ll strengthen the most:
1️⃣ Critical thinking — because you’re the one assessing, deciding, and responding independently in the home.
2️⃣ Strong clinical skills — you’re using every bit of assessment knowledge you’ve got, and then some.
3️⃣ Strong boundaries — because hospice work requires heart, but it also requires protecting your time, energy, and emotional well-being.

If you can do hospice, you can do anything. Stay confident, stay grounded, and keep growing — your skills don’t fade here… they level up.

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

11/12/2025

Tip for Hospice Nurses: I get asked so many questions about how to document on pts with Senile Degeneration of the Brain. I think the struggle is more with the attempts to document decline every visit.

We know our pts will not show decline at every visit, so instead of focusing on decline, focus on supporting eligibility in every note.

I recommend structuring every note so your documentation naturally flows to support eligibility. Following my H.E.A.R.T.S. Format makes this so easy.

The DAHN app has this template built in to all the notes and tons of phrases you can quickly include to support eligibility for every hospice diagnosis - you can get it on the App Stores, or at www . DAHN.ai

You can also find more education and phrases in my Hospice Documentation Books - check them out on my website: www. AmityStaffing . com

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

11/11/2025

Hospice agencies nationwide are rethinking how they staff.

The Amity Way provides local, reliable professionals who integrate seamlessly into your agency, bringing stability, coverage, and confidence to your team.

Discover the Amity Way at amitystaffing.com today!
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11/11/2025

Tips for Hospice Nurses: when I was a new hospice nurse I struggled with not having immediate access to advanced diagnostic tests and equipment, like when I worked in an acute care hospital.

When my pt displayed signs of having experienced a medical event such as an MI, CVA or TIA, I really struggled with wanting to immediately send them to the hospital for tests.

I was fortunate to have an amazing preceptor and medical director who taught me that we treat the pt and not the test or machine, and that our job is to first relieve their symptoms, then educate them on their options and allow the patient to make an informed decision about what steps, if any, to take next.

I always assure my pt that no matter what they decide, we will be there to help and support them, and if they do decide to revoke hospice we will not be upset with them.

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

11/10/2025

Tips for Hospice Nurses: There 3 ways a patient can discharge live from hospice, and it is important that we code the live discharge correctly.

1. Revocation: this is when the patient revokes their consent for hospice to bill Medicare. Only the patient can initiate a revocation. The hospice cannot “revocate” a patient. The most common reason a pt revokes is to seek active treatment.
2. Discharge: the 3 main reasons a hospice may discharge a pt from service is when they no longer meet criteria (eligibility), if clinician safety is of concern (cause), or if the pt moves out of their service area without notifying the hospice.
3. Transfer: if the pt wishes to change to another local hospice, or if the pt moves out of your service area, but wants to continue hospice.

All of these discharge dispositions have different regulations and considerations, so follow your agency’s policy(s) on live discharge.

Be safe out there … I love you guys! Xoxo~Shelley 💕

www.AmityStaffing.com

11/08/2025

Tips for Hospice Nurses: The Business of Hospice, Part 5

TIPS FOR HOSPICE NURSES: Continuing on with my series on the business of hospice, so that we as clinicians can learn to speak the language of our financial leaders. The goal is to shift the burden of cost away from patient care and onto process improvements, freeing up resources to better serve our patients.

This week’s topic focuses on the importance of capturing secondary and comorbid conditions. At Amity’s Chart Audit Division, we’re seeing a rise in denials that stem from incomplete diagnoses — charts listing only the terminal illness, without any secondaries or comorbidities. These denials can cost agencies thousands, even hundreds of thousands of dollars.

Here are a few ways to make identifying additional diagnoses easier:
1️⃣ Review the medications — every medication points back to a diagnosis.
2️⃣ Talk to the family or caregiver — they often know conditions that aren’t in the chart.
3️⃣ Dig into past medical history — especially after admission, when more records become available.
4️⃣ Collaborate with your interdisciplinary team — social workers, aides, and chaplains often uncover details that point to underlying conditions or functional declines that support secondary diagnoses.

If your agency could use help identifying high-risk documentation gaps, Amity offers high-level chart audits that target issues that cost money or create compliance risk. Learn more at
www . Amitystaffing . com

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

11/08/2025

Tips for Hospice Nurses: The Business of Hospice, Part 5

TIPS FOR HOSPICE NURSES: Continuing on with my series on the business of hospice, so that we as clinicians can learn to speak the language of our financial leaders. The goal is to shift the burden of cost away from patient care and onto process improvements, freeing up resources to better serve our patients.

This week’s topic focuses on the importance of capturing secondary and comorbid conditions. At Amity’s Chart Audit Division, we’re seeing a rise in denials that stem from incomplete diagnoses — charts listing only the terminal illness, without any secondaries or comorbidities. These denials can cost agencies thousands, even hundreds of thousands of dollars.

Here are a few ways to make identifying additional diagnoses easier:
1️⃣ Review the medications — every medication points back to a diagnosis.
2️⃣ Talk to the family or caregiver — they often know conditions that aren’t in the chart.
3️⃣ Dig into past medical history — especially after admission, when more records become available.
4️⃣ Collaborate with your interdisciplinary team — social workers, aides, and chaplains often uncover details that point to underlying conditions or functional declines that support secondary diagnoses.

If your agency could use help identifying high-risk documentation gaps, Amity offers high-level chart audits that target issues that cost money or create compliance risk. Learn more at
www . Amitystaffing . com

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

11/05/2025

From $45 hotel nights and cold pizza to nationwide success, that’s how The Amity Group began.

Adam hit the road himself, visiting Hospice agencies door to door across the South.

Today, Amity supports Hospice agencies in multiple states, still built on that same hands-on dedication to doing Hospice staffing the right way.
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11/05/2025

Tips for Hospice Nurses:
While the initiation of HOPE has actually been fairly painless (I haven’t been hearing many issues with it) I have been seeing some confusion about how to document e-kit medications. So I did a deep dive to see if I could get you some clarity.

Per CMS: In HOPE, when you’re documenting a PRN opioid, your options are:
1 = Initiated (choose you gave detailed instruction to the patient or caregiver on how to administer the medication … even if no dose was given yet)
2 = Continued (chose when the medication was already being taken prior to admission … even if you wrote a new hospice order for it)
0 = No (the medication is in the home, such as in an e-kit, but no instructions were given and no use has begun … it’s just at the ready, but not needed now).

In short:
- [ ] if the patient is having strong symptoms, such as dyspnea, and you anticipate the med will be needed, so you give the cg detailed instructions … mark this as a Code 1 = Yes, initiated.
- [ ] if the patient is not currently having active symptoms, and you are just putting the e-kit in the home to have in the event of an emergent situation, and not giving the cg any specific instructions … mark as a Code 0 = No
- [ ] if the patient is already taking the medication, even if you write a new hospice order … mark as a Code 2 = Yes, continued

At The Amity Group, we’re advancing the art of hospice nursing and leading the future of hospice care.
www . Amitystaffing . com

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

11/04/2025

Tips for Hospice Nurses: Bag technique. We all struggle with it, especially trying to remember every single step for survey. But if we rethink it, it gets easier. Bag technique isn’t just about compliance—it’s about protecting you. It keeps your bag clean, the things in your bag clean, and makes sure when that bag goes in your car or your home, it’s not carrying germs back to your family.

That’s why I love the TagBag™ I designed. It makes following bag technique second nature:
- [ ] No setting the bag on floors or surfaces = less contamination.
- [ ] Comfortable to wear all day without digging into your shoulder.
- [ ] Easy access to gloves, sanitizer, and supplies right when you need them.
- [ ] Built to keep you organized and efficient.
Bag technique doesn’t have to feel like a checklist, it can be simple, intuitive, and protective when you shift how you think about it.
Ya’ll be safe out there! I love you guys … xoxo ~ Shelley 💕

11/01/2025

Tips for Hospice Nurses: Home inspections aren’t just for patient safety, they’re for ours too.

When you enter a new home, take a few minutes to look around for any potential risks: aggressive pets, items that are combustible or could explode easily, and any other hazards that could pose a danger. Identifying these risks early allows you and your team to plan visits safely.

And, if you spot any safety concerns, make sure your colleagues know … we look out for our patients, but we’ve got to look out for each other, too.

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

#️⃣

10/30/2025

TIPS FOR HOSPICE NURSES: If you’re making this one documentation mistake, stop right now because it’s not just risking your license, it’s risking your freedom.

The mistake: documenting all your Sup. Visits at 8:00–8:15am while actually completing them later in the day. That is physically impossible and looks like fraud. If a Sup. Visit was completed during a previous nurse visit, document it as a late entry and include the actual date and time it was performed. You cannot batch or backdate these entries. Document in real time or protect yourself with a clear late-entry note.

EMR metadata makes it very easy to catch this mistake. Be accurate, be honest, and protect yourself.

Need help? If you need services from Amity’s Hospice Audit Division, learn more at Amitystaffing. com. For documentation support, get the Documentation App for Hospice Nurses at DAHN.ai or in the app stores.

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

The Amity Group

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