What to Document During the IDG Meeting: A Guide for Medicare-Certified Hospice Agencies

The Interdisciplinary Group (IDG) meeting is more than just a routine team check-in—it is the regulatory heart of hospice care planning. According to Medicare’s Conditions of Participation (CoPs), hospices must use a coordinated, patient-centered approach led by a designated IDG. This group is responsible for assessing, planning, and evaluating care for each patient and their family.

To remain compliant and deliver high-quality, individualized hospice services, proper documentation of the IDG process is essential. Here's what every Medicare-certified hospice agency should include in its IDG documentation.

Core IDG Composition and Roles

Every hospice must designate an IDG that includes, at a minimum:

• A physician (employee or contracted),

• A registered nurse,

• A social worker, and

• A pastoral or other counselor.

A registered nurse member of the IDG is responsible for coordinating the program, ensuring continuous assessment of the patient and family’s needs, and guiding plan of care implementation and revisions.

If your hospice operates with multiple IDGs, at least one designated IDG must be responsible for establishing and maintaining day-to-day policies and procedures.

What Must Be Documented in the IDG Meeting?

During the IDG meeting, documentation should reflect a collaborative review and update of the patient's individualized plan of care. This includes:

1. Assessment Updates

• Information from the latest comprehensive assessment.

• Any change in the patient's condition, needs, or functional status.

• Progress (or lack thereof) toward goals or outcomes previously established.

2. Plan of Care Review and Revision

The plan of care must be reviewed at least every 15 calendar days, or more frequently based on the patient's condition.

Documentation must reflect:

• Specific goals and outcomes desired by the patient and family.

• Interventions to address identified needs.

• A detailed statement of the scope and frequency of hospice services (e.g., nursing visits, aide services, social work, chaplaincy).

• PRN visits must have clearly documented rationale (not used as standalone frequency).

• Medications, treatments, medical supplies, and equipment in use.

• Evidence that the patient/representative received education and training as outlined in the care plan.

3. Patient and Family Involvement

• Notes must show collaboration with:

  • The patient and/or their representative,

  • The attending physician (if any),

  • The primary caregiver.

• Document understanding, agreement, or refusal of the plan of care.

4. Eligibility and Subjective Evidence

Use free text fields in your EHR to provide individualized documentation:

• Subjective comments like:
  “Patient reports increased fatigue and no longer wishes to go outside.”
  

• Clinical observations such as:
  “Patient ambulated only 5 feet with assistance today; previously ambulated 15 feet.”
  

5. Coordination of Care

The IDG must document:

• Communication between all disciplines and providers (including contracted services).

• Coordination with non-hospice healthcare providers for unrelated conditions.

• Response and follow-up to status changes or emergency events.

Best Practices for IDG Documentation

To optimize your IDG meeting process and ensure regulatory compliance:

• Use structured templates that prompt IDG members to address each required area.

• Avoid “report-style” meetings—focus on collaborative care planning and meaningful updates.

• Document collaboration with the attending physician, even if not present (e.g., phone call summaries, message exchanges).

• Include measurable outcomes that align with updated assessments.

• Emphasize individualization—expand beyond drop-downs and “point-and-click” entries.

• Educate staff during onboarding and provide ongoing training about IDG documentation standards.

Final Thoughts

Proper IDG meeting documentation is a critical compliance obligation under Medicare's hospice CoPs. It ensures that patients receive coordinated, high-quality care that aligns with their needs, values, and disease progression. More importantly, it protects your agency from survey deficiencies and supports accurate, defensible billing practices.

By training your team, updating your processes, and continuously monitoring your documentation practices, your hospice agency can ensure it remains compliant, compassionate, and centered on the needs of every patient and family you serve.