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   Specializing in end-of-life care since 1978



 

 

 

 

 

 

 

 


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Reporting Volunteer Hours and Patient Notes


Your volunteer hours are very important to this organization. Seacoast Hospice is a Medicare-funded agency and our funding requires that 5% of our total patient care hours be provided by volunteers. Only your reported hours can be recorded and counted toward this requirement.  An asterisk indicates the information on the form below is required for sending.


Volunteer's Name*: Mr. Ms. Mrs. Miss 


Volunteer's Email*:

 

Date of Service Patient
(used only for direct service)		 Activity Code   Duration
  (hours)		  
 
 
 
 
 
 
 
 

 

Code Direct Patient Care Code General Support
101 Direct Care (Visits with patients in patient homes and facilities, vigils, pastoral care visitsm, Reiki) 301 Board of Directors
102 Bereavement & Bridges (includes group facilitation, one-on-one patient/family contact and patient/family phone calls) 303

Fundraising
104 HFHH (direct care, front desk and/or kitchen) 304 Public Relations (includes BOATING, speaker's bureau and assistance at vaious information fairs)
Code Patient Care Support 305 Projects (includes gardening/labyrinth, knitting, JorneySong, etc.)
201 Administration (includes clerical office tasks, library, data entry) 306 Volunteer Training and Education (includes initial 30+ hour training, in-services, quarterly meetings, or participation in training to become a bereavement and/or Bridges facilitator or other specialty training such as pastoral care, Reiki, etc.)

 

 Travel Time:

Travel time according to Medicare's Conditions of Participation (COPs) can olny be included in your hours when traveling to and from transporting or doing another direct care (101, 102, 104) task.  Travel time cannot be claimed for other codes of volunteer service.



 Patient Notes: 

Medicare requires that for every direct care visit you make (code 101 or 104) you also must include a sentence about your observations of that patient.

 Notes/Comments:






    • Thank you for reporting your MONTHLY hours by the 5th of the following month.