Question about hospital policy

[Fatalis]

Hey everyone, quick question and I need a source regarding the answers; haven't found anything.
Long story short, group practice and we take turns taking call/ admitting patients overnight. One provider refuses to come in at 1am to do an H&P on the patient and even refuses to come in at 6am [we switch over at 7am] to do the H&P. Basically they are saying that if they fall asleep, they will take care but won't come in for documentation and just leave it for the morning person. Correct if I am wrong, but if you are the admitting physicians, isn't it your duty/obligation to do the H&P? If so/ not could I get a source/ written rule on this. Thanks!

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[NotAProgDirector]

There's no "rule" about this anywhere, it's totally up to the practice / hospital.

Some places have a nocturnist write an H&P from midnight to 8 AM. Other places have the ED write holding orders, and then the hospitalists write the H&P the next day. You can only bill for one note per service per day, so as long as the admission is after midnight, there's no billing penalty to writing the H&P in the AM.

If the patient gets admitted "under your name" between midnight and 8AM, you are responsible for their care. If something goes wrong, you are absolutely on the hook even if you never saw nor heard about the patient. Most ED's that work this way will call you to discuss the patient.

For any group practice, it's critical that everyone is playing by the same rules. Either you are expected to write H&P's after midnight, or not. If not, you always have the option of doing it anyway if you want to -- might be beneficial from a medmal perspective, and also from an RVU.

 

[dpmd]

Pretty sure the hospital is going to say an h an p needs to be completed within 24 hrs of admission for admitted patients. This is something that needs to be addressed with a group policy.

 

[Fatalis]

Thanks so much for the info!