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Posted on July 12, 2020 at 6:40 PM

The Veterans Affairs Office of Inspector General just released an inspection report of the Oscar G. Johnson VA Medical Center in Iron Mountain, Michigan. Care coordination concerning life-sustaining treatment decisions was one of the four focus areas.


VHA requires practitioners to initiate goals of care conversations with high-risk patients—including hospice patients or their surrogates—within a time frame that meets the medical needs of the patient or at the time of a triggering event. The GOC conversations are discussion between a healthcare provider and a patient or surrogate to help define the patient’s values, goals, and preferences for care and, based on the discussion, make choices about starting, limiting, or ceasing LSTs.


The OIG found that the medical center generally complied. But it expressed concern that a new VHA requirement could mislead practitioners to only address those goals of care conversation elements that are required to be documented in the LST progress note.


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