Ill. HFS Handbook for Hospice Agencies, Topic K-202

The Department regards the maintenance of adequate records essential for the

delivery of quality medical care. In addition, providers should be aware that medical

records are key documents for post-payment audits. Refer to Chapter 100 for record

requirements applicable to all providers.

In the absence of proper and complete medical records, no payment will be

made and payments previously made will be recouped. Lack of records or

falsification of records may also be cause for a referral to the appropriate law

enforcement agency for further action.

The minimal record requirements satisfying Department standards for hospice

services are as follows:

• Identification of the participant: name, address, case identification number,

recipient identification number and age

• Complete and current diagnosis

• Name of ordering practitioner

• Statement of election of hospice benefits

• Statement by physician regarding terminal illness including diagnosis and

prognosis

• Multidisciplinary team plan of care

• Contractual agreements between the hospice provider and long term care

facilities

• Contractual agreements between the hospice provider and acute care

hospitals