{"id":1072,"date":"2022-11-14T07:45:12","date_gmt":"2022-11-14T07:45:12","guid":{"rendered":"http:\/\/frescogamingstudio.com\/hospice\/?page_id=1072"},"modified":"2026-02-02T03:39:22","modified_gmt":"2026-02-02T03:39:22","slug":"certification-cti","status":"publish","type":"page","link":"https:\/\/caremust.com\/hospice\/certification-cti\/","title":{"rendered":"Certification CTI"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1072\" class=\"elementor elementor-1072\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-350b9046 elementor-section-height-min-height elementor-section-boxed elementor-section-height-default elementor-section-items-middle\" data-id=\"350b9046\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-402c19a4\" data-id=\"402c19a4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5bafc6c de_scroll_animation_no elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"5bafc6c\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.22.0 - 26-06-2024 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h1 class=\"elementor-heading-title elementor-size-default\">Certification CTI\n<\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a8f1a elementor-icon-list--layout-inline elementor-align-center elementor-list-item-link-full_width de_scroll_animation_no elementor-invisible elementor-widget elementor-widget-icon-list\" data-id=\"a8f1a\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_delay&quot;:200}\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<link rel=\"stylesheet\" href=\"https:\/\/caremust.com\/hospice\/wp-content\/plugins\/elementor\/assets\/css\/widget-icon-list.min.css\">\t\t<ul class=\"elementor-icon-list-items elementor-inline-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\">\n\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">HOME<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-inline-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-star-of-life\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">CERTIFICATION CTI<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5d4ab031 elementor-reverse-tablet elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5d4ab031\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2c4b4446\" data-id=\"2c4b4446\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-39ddda65 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"39ddda65\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-2c47f3d elementor-invisible\" data-id=\"2c47f3d\" data-element_type=\"column\" data-settings=\"{&quot;animation&quot;:&quot;fadeInUp&quot;,&quot;animation_delay&quot;:600,&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5713622d de_scroll_animation_no elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"5713622d\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_delay&quot;:200}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Certification CTI (pcp)<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1116757 cti de_scroll_animation_no elementor-widget elementor-widget-shortcode\" data-id=\"1116757\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1081-o1\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/hospice\/wp-json\/wp\/v2\/pages\/1072#wpcf7-f1081-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1081\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.9.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1081-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<p><label>Attach Document (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"AttachDocument\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\"audio\/*,video\/*,image\/*\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"AttachDocument\" \/><\/span><\/label>\n<\/p>\n<p>In order to determine if a patient is eligible for Hospice benefit we are required to have physician's authorization with a brief narrative supporting terminal illness.\n<\/p>\n<p><span class=\"class2\">Patient Name:<\/span>\n<\/p>\n<div class=\"name-field\">\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"menu-747\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"menu-747\"><option value=\"Mr\">Mr<\/option><option value=\"Miss\">Miss<\/option><\/select><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"text-964\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"First Name*\" value=\"\" type=\"text\" name=\"text-964\" \/><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"text-765\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Last Name\" value=\"\" type=\"text\" name=\"text-765\" \/><\/span>\n\t<\/p>\n<\/div>\n<div class=\"name-field tel\">\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tel-508\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Your Phone*\" value=\"\" type=\"tel\" name=\"tel-508\" \/><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"email-598\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Your Email*\" value=\"\" type=\"email\" name=\"email-598\" \/><\/span>\n\t<\/p>\n<\/div>\n<p><span class=\"class3\">Statement for First 90-\u00ad\u2010day period<\/span>\n<\/p>\n<p><span class=\"class4\">Verbal Authorization Date:<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-207\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-207\" \/><\/span><span class=\"class5\"> Effective Date of Certification:<span class=\"wpcf7-form-control-wrap\" data-name=\"date-888\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-888\" \/><\/span><\/span>\n<\/p>\n<p><span class=\"class4\">Terminal Diagnosis:<span class=\"wpcf7-form-control-wrap\" data-name=\"text-577\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-577\" \/><\/span><\/span>\n<\/p>\n<p>It is my clinical judgment that this patient has a life expectancy of six months or less, if the terminal illness runs its normal course. My signature constitutes approval to admit to Hospice. I have been encouraged to participate in the IDG Meetings and Plan of Care if I choose to follow the Patient.\n<\/p>\n<p><span class=\"class6\">Name*:<\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-214\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"checkbox-214[]\" value=\"Referring MD\" \/><span class=\"wpcf7-list-item-label\">Referring MD<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-214[]\" value=\"PCP\" \/><span class=\"wpcf7-list-item-label\">PCP<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"checkbox-214[]\" value=\"Other MD\" \/><span class=\"wpcf7-list-item-label\">Other MD<\/span><\/span><\/span><\/span>\n<\/p>\n<p><span class=\"class6\">Signature*: <\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-187\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"checkbox-187[]\" value=\"Referring MD\" \/><span class=\"wpcf7-list-item-label\">Referring MD<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-187[]\" value=\"PCP\" \/><span class=\"wpcf7-list-item-label\">PCP<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"checkbox-187[]\" value=\"Other MD\" \/><span class=\"wpcf7-list-item-label\">Other MD<\/span><\/span><\/span><\/span>\n<\/p>\n<p><span class=\"class1\">Patient Follow-\u00ad\u2010Up (Please check one)<\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-17\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"checkbox-17[]\" value=\"I DO\" \/><span class=\"wpcf7-list-item-label\">I DO<\/span><\/span><\/span><\/span> wish to be contacted directly should the need arise for a change in the current plan of care. The Hospice Physician can be designated in my absence. I wish to sign the Death Certificate. The Hospice Physician can follow for pain and symptom management.\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-448\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"checkbox-448[]\" value=\"DO NOT\" \/><span class=\"wpcf7-list-item-label\">DO NOT<\/span><\/span><\/span><\/span> want to follow the patient and\/or sign the death certificate.\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-3f31de8f elementor-invisible\" data-id=\"3f31de8f\" data-element_type=\"column\" data-settings=\"{&quot;animation&quot;:&quot;fadeInUp&quot;,&quot;animation_delay&quot;:700,&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3ffcb44 de_scroll_animation_no elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"3ffcb44\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_delay&quot;:200}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Certification CTI Medical Director<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-650da73 cti rgt de_scroll_animation_no elementor-widget elementor-widget-shortcode\" data-id=\"650da73\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1082-o2\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/hospice\/wp-json\/wp\/v2\/pages\/1072#wpcf7-f1082-o2\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1082\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.9.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1082-o2\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<p>In order to determine if a patient is eligible for Hospice benefit we are required to have physician's authorization with a brief narrative supporting terminal illness.\n<\/p>\n<p>Patient Name:\n<\/p>\n<div class=\"name-field\">\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"menu-722\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"menu-722\"><option value=\"Mr\">Mr<\/option><option value=\"Miss\">Miss<\/option><option value=\"Mrs\">Mrs<\/option><\/select><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"text-837\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"First Name*\" type=\"text\" name=\"text-837\" \/><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"text-486\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Last Name*\" value=\"\" type=\"text\" name=\"text-486\" \/><\/span>\n\t<\/p>\n<\/div>\n<p>Certification #1: Statement for First 90-\u00ad\u2010day period\n<\/p>\n<p>I certify that <span class=\"wpcf7-form-control-wrap\" data-name=\"text-444\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-444\" \/><\/span> has a life expectancy of six months or less, if the terminal illness runs its normal course.\n<\/p>\n<p>Verbal Authorization Date:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-264\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-264\" \/><\/span> Obtained by:<span class=\"wpcf7-form-control-wrap\" data-name=\"text-587\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-587\" \/><\/span>\n<\/p>\n<p>Effective Date of Certification:\n<\/p>\n<p>Primary DX*:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-991\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-991\" \/><\/span>\n<\/p>\n<p>Secondary DX*:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-446\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-446\" \/><\/span>\n<\/p>\n<p>Comorbidities*:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-9\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-9\" \/><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-799\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"checkbox-799\" value=\"Medical history,record and patient status\" \/><span class=\"wpcf7-list-item-label\">Medical history,record and patient status<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-799\" value=\"Team Assessment\" \/><span class=\"wpcf7-list-item-label\">Team Assessment<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"checkbox-799\" value=\"Face to Face Encounter\" \/><span class=\"wpcf7-list-item-label\">Face to Face Encounter<\/span><\/span><\/span><\/span>\n<\/p>\n<p>ADL*:<span class=\"wpcf7-form-control-wrap\" data-name=\"text-89\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-89\" \/><\/span>\n<\/p>\n<p>Functional Status*: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-301\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-301\" \/><\/span>\n<\/p>\n<p>LCD Determination Status*: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-732\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-732\" \/><\/span>\n<\/p>\n<p>RN Assessment Narrative*: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-102\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-102\" \/><\/span>\n<\/p>\n<p>Physician Narrative*: <span class=\"wpcf7-form-control-wrap\" data-name=\"text-889\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-889\" \/><\/span>\n<\/p>\n<p>Medical Director Attestation\/Certification\n<\/p>\n<p>I attest\/confirm that I composed this narrative based on my review of patient\u2019s medical records, team assessment and\/or examination of the patient.\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-22\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"checkbox-22[]\" value=\"Medical Director\" \/><span class=\"wpcf7-list-item-label\">Medical Director<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-22[]\" value=\"Physician Designee\" \/><span class=\"wpcf7-list-item-label\">Physician Designee<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"checkbox-22[]\" value=\"Referring MD (if attending)\" \/><span class=\"wpcf7-list-item-label\">Referring MD (if attending)<\/span><\/span><\/span><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Learn about CTI (Care Transitions Intervention) certification at Care Must Hospice, part of our commitment to compliance and quality hospice care standards.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/caremust.com\/hospice\/wp-json\/wp\/v2\/pages\/1072"}],"collection":[{"href":"https:\/\/caremust.com\/hospice\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/caremust.com\/hospice\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/caremust.com\/hospice\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/caremust.com\/hospice\/wp-json\/wp\/v2\/comments?post=1072"}],"version-history":[{"count":59,"href":"https:\/\/caremust.com\/hospice\/wp-json\/wp\/v2\/pages\/1072\/revisions"}],"predecessor-version":[{"id":2854,"href":"https:\/\/caremust.com\/hospice\/wp-json\/wp\/v2\/pages\/1072\/revisions\/2854"}],"wp:attachment":[{"href":"https:\/\/caremust.com\/hospice\/wp-json\/wp\/v2\/media?parent=1072"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}