Hospice Admission Checklist

Streamline hospice admissions with Carepatron's comprehensive checklist app. Enhance patient care with our free PDF guide and expert tips.

By RJ Gumban on Jul 15, 2024.


Fact Checked by Ericka Pingol.

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What is a Hospice Admission Checklist Template?

In the compassionate world of hospice care, where every action is a blend of empathy and expertise, the Hospice Admission Checklist Template emerges as a beacon of guidance and support. Designed for healthcare professionals, this template is not just a form; it's a roadmap to providing holistic, patient-centered care at a critical juncture in a patient's journey.

A Hospice Admission Checklist Template is a comprehensive tool that helps streamline the process of admitting a patient into hospice care. It is a detailed guide, ensuring all necessary steps are taken to provide the best care. This includes assessing the patient's medical history, current health status, medication needs, and personal preferences for end-of-life care. This checklist ensures nothing is overlooked in an environment where every detail counts.

The beauty of this template lies in its ability to bring clarity and order during a time that can be emotionally challenging for patients and their families. It's a tool that aids healthcare professionals in their clinical duties and their role as compassionate caregivers. Each item on the checklist is a step towards creating a comforting, respectful, and dignified experience for those entering hospice care.

Integrating the Hospice Admission Checklist into your practice becomes seamless with practice management software from Carepatron. This software enhances the functionality of the checklist, allowing for digital record-keeping, easy updates, and efficient information sharing among the care team.

In summary, the Hospice Admission Checklist Template is essential in hospice care, ensuring that patients receive comprehensive and compassionate care during their most vulnerable times.

Hospice Admission Checklist Template

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Hospice Admission Checklist Example

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How do you use the Hospice Admission Checklist Template?

Utilizing the Hospice Admission Checklist template effectively ensures a comprehensive and compassionate approach to patient admission in hospice care. Here’s a step-by-step guide:

Gather essential patient information

Begin by filling in the patient's name, date of birth, contact information, emergency contact details, and admission date. This foundational information is vital for identifying patients and establishing their profile in the hospice system.

Document medical history

Record the patient's primary diagnosis, other relevant conditions, current medications, allergies, and recent hospitalizations. This comprehensive medical history helps tailor the care plan to the patient's health needs.

Specify care preferences

Detail the patient's advanced directives, pain management preferences, spiritual or religious needs, communication preferences, and end-of-life care wishes. Understanding these preferences is critical to providing patient-centered care.

Assess logistical needs

Identify any equipment requirements, dietary restrictions, personal belongings the patient wishes to have, mobility assistance needs, and room preferences. These logistical details ensure the patient's comfort and safety in the hospice setting.

Review admission agreements

Ensure all consent forms are signed, financial and insurance information is recorded, privacy acknowledgments are completed, and admission paperwork is filed. This step is crucial for legal and administrative compliance.

Develop an initial care plan

Based on the assessment by the hospice team, establish care goals, schedule visits, and plan any additional services such as physical therapy or dietary consultation. Include family support plans if necessary.

The Hospice Admission Checklist template is invaluable for healthcare professionals, ensuring that every aspect of a patient's admission into hospice care is thoroughly and compassionately addressed.

When would you use this form?

The Hospice Admission Checklist Template is designed for specific scenarios in hospice care where detailed and accurate patient information is vital. Here are some situations where this template is particularly beneficial:

  • At the time of patient admission: Essential for capturing comprehensive information when a patient is first admitted to hospice care.
  • During the transition from hospital to hospice: Use this checklist to ensure a seamless transition, maintaining continuity of care by documenting all necessary patient information.
  • For annual reviews or reassessments: Ideal for conducting thorough studies or reassessments of a patient's care plan, ensuring all changes in health status or care preferences are updated.
  • In family meetings and care discussions: The checklist is a reference point, enabling clear communication about the patient's care plan and current status.
  • For compliance and quality assurance: Helps meet healthcare standards and quality assurance requirements, ensuring comprehensive and compliant patient care documentation.

The Hospice Admission Checklist Template is a vital resource in hospice care, facilitating detailed and compassionate care planning tailored to each patient's unique needs.

What do the results mean?

Interpreting the results gathered from the Hospice Admission Checklist is crucial in providing tailored and compassionate care to patients in hospice settings. Here's what these results typically signify:

Understanding patient needs

The information collected offers a comprehensive view of the patient's medical condition, care preferences, and logistical requirements. This understanding is essential for creating a care plan that addresses patients' needs and wishes, ensuring they receive the most appropriate and personalized care.

Tailoring the care plan

The detailed medical history, including diagnoses and medications, helps anticipate potential health complications and plan appropriate interventions. The care preferences and logistical needs inform the daily care routines, ensuring the patient's comfort and dignity are maintained.

Facilitating communication

The checklist is a communication tool among the hospice care team, ensuring everyone involved in the patient's care is informed and aligned. This coordinated approach is vital for delivering consistent and effective care.

Ensuring compliance and quality

The completed checklist also acts as a record of compliance with healthcare standards and regulations. It demonstrates that the hospice facility is committed to providing high-quality care and respecting patients' rights and preferences.

The results from the Hospice Admission Checklist are instrumental in shaping the patient's journey through hospice care. They ensure that each patient's unique situation is understood and respected, leading to a care experience that is as comfortable and meaningful as possible.

Research & evidence

The Hospice Admission Checklist template is a critical tool in hospice care, supported by research and evidence emphasizing its importance in patient care and healthcare documentation. Here's a summary of the research and evidence:

  • Clinical practices in palliative care: A study by de Graaf et al. (2022) examined clinical practices in palliative care across different types of hospices in The Netherlands. The study found significant variations in care practices, highlighting the need for standardized tools like the Hospice Admission Checklist to ensure consistent and quality care.
  • Decision-making in hospice admissions: Eagle and de Vries (2005) explored the decision-making processes during multidisciplinary meetings for prioritizing hospice inpatient admissions. Their findings underscore the complexity of hospice admissions and the importance of having a structured approach, as provided by the checklist.
  • Symptom assessment in palliative care: Coym et al. (2020) evaluated patients’ main symptoms and problems at admission to a specialist inpatient palliative care ward. The study emphasizes the need for systematic sign and problem assessment, a vital component of the Hospice Admission Checklist.
  • Variation in hospice patient and admission characteristics: A study by Furuno et al. (2020) described the associations between hospice referral locations and patient characteristics. This research highlights the diversity in hospice patient needs, further supporting the use of a comprehensive admission checklist to cater to varying patient requirements.


Coym, A., Ullrich, A., Hackspiel, L. K., Ahrenholz, M., Bokemeyer, C., & Oechsle, K. (2020). Systematic symptom and problem assessment at admission to the palliative care ward – perspectives and prognostic impacts. https://dx.doi.org/10.1186/s12904-020-00576-3.

de Graaf, E., Grant, M., van de Baan, F., Ausems, M., Verboeket-Crul, C., Leget, C., & Teunissen, S. (2022). Variations in Clinical Practice: Assessing Clinical Care Processes According to Clinical Guidelines in a National Cohort of Hospice Patients. https://dx.doi.org/10.1177/10499091221100804.

Eagle, L. M., & de Vries, K. (2005). Exploration of the decision-making process for inpatient hospice admissions. https://dx.doi.org/10.1111/J.1365-2648.2005.03630.X.

Furuno, J., Noble, B., Mcpherson, M., Lapane, K., Sera, L., Izumi, S., & Tjia, J. (2020). Variation in Hospice Patient and Admission Characteristics by Referral Location. https://dx.doi.org/10.1097/MLR.0000000000001415.

How secure is patient data on Carepatron?
How secure is patient data on Carepatron?

Commonly asked questions

How secure is patient data on Carepatron?

Carepatron ensures the highest level of security for patient data. The platform uses advanced encryption and complies with healthcare privacy regulations to protect sensitive information.

Can Carepatron's Hospice Admission Checklist be customized?

Yes, Carepatron allows for customizing the Hospice Admission Checklist to suit specific needs and preferences, ensuring that it aligns perfectly with your hospice care protocols.

Is Carepatron accessible on various devices?

Absolutely. Carepatron is designed for accessibility across multiple devices, including smartphones, tablets, and computers, enabling healthcare professionals to update and view checklists anytime, anywhere.

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