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Free hospice documentation templates
Printable visit note templates for every major hospice diagnosis — built around CMS LCD criteria so every field maps to what an ADR reviewer checks.
No sign-up required. Open a template, hit Print in your browser, and you have a structured reference for your next visit.
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LCD L34538
Dementia / Alzheimer's Disease
Use this template at every routine visit to document the specific findings that support hospice elig…
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LCD L34538
Cardiac Disease / Congestive Heart Failure
CHF charts live or die on specifics: daily weight trend, NYHA class, documented EF, and symptom burd…
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LCD L34538
Pulmonary Disease (COPD / ILD / Emphysema)
The two most common audit failures for pulmonary patients: (1) documenting dyspnea but not documenti…
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LCD L34538
Cancer (All Types)
Cancer charts are often the strongest in hospice — but ADRs still target them when PPS is borderline…
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LCD L33393
General Decline / Failure to Thrive (Non-Disease Specific)
LCD L33393 applies when no single diagnosis dominates the terminal picture — multi-morbid patients, …
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LCD L34538 / L33393
IDG / IDT Meeting Documentation
The IDG is the clinical and compliance backbone of every benefit period. CMS requires a meeting at l…
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LCD L34538 / L33393
Recertification Narrative Template
The recertification narrative is the document auditors read most carefully. Generic language and cop…
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LCD L34538 / L33393
Hospice Aide Care Plan
The aide care plan must be individualized, authorized by the RN, and updated at each care plan revie…
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LCD L34538
ALS / Motor Neuron Disease
Coming soon📄
LCD L34538
Liver Disease / Cirrhosis
Coming soon📄
LCD L34538
Renal Disease / CKD Stage 5
Coming soon📄
LCD L34538
Stroke / Coma
Coming soonWhy these templates are structured differently
Built around the LCD, not a generic visit note
Every section maps to a specific criterion in L34538 or L33393. If a field is on the template, it's there because auditors look for it.
ADR-tested documentation language included
Each template includes sample documentation language modeled on what survives Medicare ADR review — specific, observable, connected to the criteria.
Common mistakes section per diagnosis
The most frequent charting gaps we see in denied claims are listed at the bottom of each template so you know what to double-check before filing.
Printable — no account needed
Open the template, use your browser's print function (Cmd+P / Ctrl+P), and you have a structured reference sheet. No PDF download required.
Prefer not to fill out paper forms?
NotePush generates these notes from your visit
Walk through a guided 12-step wizard that asks exactly what these templates ask — then get a complete, LCD-aligned visit note ready to paste into your EMR. Free for synthetic patients; $29/nurse/month for real-patient mode.
Try NotePush free →