This is not a generic form pulled from a search result. It was built from real clinical and caregiving experience, tested against the actual situation you are facing, whether that is a visit, a chart, or a hard conversation. Download it and start using it right away. There is no software to install and no training required first. Use it exactly as it is, or adjust it to fit how your team or your family already works. Either way, you get a clear, ready-made tool instead of one more thing to build from scratch.

The chart looks fine on the surface: plan of care updated, visits documented, IDG notes current. But nobody scheduled a face-to-face encounter before the third benefit period started, and now it's too late.

Here's the part that catches most agencies off guard. A missed face-to-face (F2F) encounter isn't a documentation problem you can fix with a late entry. Once the 31-day window closes with no visit from a hospice physician or hospice nurse practitioner, the patient is no longer eligible for that benefit period. No appeal. No grace period. You discharge the patient from the Medicare hospice benefit, keep caring for them at your own expense, complete the encounter, and readmit them with a brand new election.

For an agency billing at the FY 2027 routine home care rate of $186.35 per day, one missed 60-day benefit period results in over $11,000 in lost revenue, on top of the staff hours spent discharging, documenting, and readmitting a patient who should never have left the benefit in the first place.

And this requirement is genuinely hard to track by hand. Four things make it so.

The window moves. It's only 31 days wide, and it shifts every 60 days for every patient who has passed day 180. An agency with 20 long-stay patients is juggling 20 windows that never line up on the same calendar.

Prior hospice days count. A transfer patient may already be in their fifth benefit period due to care at a different hospice. If your team is only counting days at your own agency, that deadline will sneak up on you with zero warning.

Fewer people can perform the visit than most staff assume. Only a hospice physician or an employed hospice nurse practitioner can do it. A physician assistant, even one who's fantastic, even one who's seeing the patient regularly, cannot. This single misunderstanding shows up in policies and orientation materials across the industry.

And the rules keep changing. The attestation requirements changed on October 1, 2025. A new telehealth billing code, G0679, takes effect January 1, 2027. Most F2F forms still circulating in hospice agencies today predate both changes.

This is exactly the kind of problem that doesn't get solved by trying harder. It gets solved by a system that does the date math for you and never forgets a patient.

That's what this kit is.

Open the Active Window Worklist tab on a Monday morning, and you see every patient with an open or upcoming F2F window, sorted by urgency and color-coded green, yellow, and red. You're not hunting through 20 charts to find out who's due. The tracker already did that. Enter a patient's admission date once, and it calculates every benefit period boundary, flags the exact date their window opens and closes, and keeps a running list of who needs a visit this week.

After the visit happens, you log it, and the tracker tells you which of the three attestation templates to use: one for when the certifying physician performed the encounter, one for when a nurse practitioner or a different hospice physician did it, and one built around a signed clinical note serving as the attestation itself, the option Medicare opened up in October 2025. Each template comes as an editable Word document and a fillable PDF, so a physician signing on a tablet and an office manager customizing your letterhead both have what they need.

The tracker also won't mark a claim as billing-ready until the attestation is actually complete: the right signatures, the right dates, and the narrative sentence explaining why the encounter findings support a life expectancy of six months or less, which is the single most common thing missing from F2F documentation. And if a window does close unmet, the kit doesn't pretend that can be papered over. It walks your team straight into the honest discharge-and-readmission process because that's the only path Medicare recognizes.

Rounding out the kit is a 13-page compliance guide covering the full rule set, the recent changes with their effective dates, placement diagrams showing exactly where the attestation and narrative belong on the page, and a plain-language how-to guide written at a level any new hire on your team can follow without a training session.

You already know how to care for a patient in their fifth or eighth benefit period. This kit makes sure the paperwork never gets in the way of that care.

Get instant access and stop letting a missed date decide who stays on hospice.