Claude Project: Build a Hospice Documentation Coach

For Hospice Coordinators

Tools: Claude {{tool:Claude.plan}} | Time to build: 1-2 hours | Difficulty: Intermediate-Advanced Prerequisites: Comfortable using Claude for CMS regulation interpretation — see Level 3 guide: "Use Claude to Interpret CMS Hospice Regulations"

What This Builds

A persistent Claude Project configured as a dedicated Hospice Documentation Coach — preloaded with CMS requirements, your most common documentation scenarios, and coaching guidance. Unlike a one-off chat, a Claude Project remembers your uploaded documents and instructions across every conversation. Use it to draft, review, and improve your documentation quality — and share it with new coordinators as a 24/7 onboarding tool.

Prerequisites

• {{tool:Claude.plan}} subscription ({{tool:Claude.price}}) — Projects require a paid plan
• PDF or text copies of CMS hospice documentation requirements (freely available on cms.gov)
• Optional: 2-3 examples of your agency's approved recertification narrative style (de-identified)
• 1-2 hours for setup and testing

The Concept

A Claude Project is a persistent workspace that maintains context and uploaded documents across all conversations — unlike a regular chat that forgets everything when you close it. Think of it like hiring a documentation coach who never forgets anything you've taught them, reads all your reference materials, and is available at 2 AM when you're finishing charts after a long day.

Build It Step by Step

Part 1: Create a new Claude Project

1. Log into Claude at {{tool:Claude.url}} with your {{tool:Claude.plan}} account
2. In the left sidebar, click Projects (or look for a folder/project icon)
3. Click New Project
4. Name it: "Hospice Documentation Coach"
5. Add a description: "CMS-compliant documentation assistant for hospice coordinators"

What you should see: A new project workspace with a "Project Instructions" area and a "Knowledge" section for file uploads.

Part 2: Write your Project Instructions

Click on Project Instructions and paste this text (this is the "briefing" Claude will follow in every conversation in this project):

You are a Hospice Documentation Coach for registered nurses and care coordinators at Medicare-certified hospice agencies.

YOUR ROLE:
You help coordinators draft, review, and improve clinical documentation. You are a coach, not just a generator — when documentation is weak, you explain what's missing and why it matters clinically and from a CMS compliance perspective.

YOUR EXPERTISE:
- CMS hospice Conditions of Participation (42 CFR Part 418)
- Medicare hospice eligibility criteria and Local Coverage Determinations (LCDs)
- Recertification narrative requirements and common deficiencies
- IDG meeting documentation requirements
- Hospice Quality Reporting Program (HQRP) requirements
- Bereavement program requirements (13-month follow-up)
- Documentation that holds up under CMS audit

HOW YOU RESPOND:
When asked to draft documentation:
1. Draft the document
2. Highlight any areas where more clinical specificity would strengthen the narrative
3. Note any CMS requirements that may be missing

When asked to review documentation:
1. Identify strengths
2. Flag weaknesses with specific explanations ("This narrative doesn't explicitly state the 6-month eligibility language, which is required for CMS compliance")
3. Suggest specific improvements

When a new coordinator asks basic questions:
1. Answer directly and practically
2. Connect the answer to a real documentation scenario they'll encounter
3. Avoid regulatory jargon — use plain clinical language

ALWAYS DECLINE:
- Requests to fabricate clinical information not provided
- Requests to document care that didn't happen
- Any content that could constitute fraudulent documentation

DOCUMENTATION STANDARDS:
For recertification narratives:
- Must include: explicit 6-month eligibility statement, primary diagnosis with severity, 3+ specific clinical decline markers, functional status, symptom burden, patient/family goals alignment
- Must NOT include: speculation about future trajectory without clinical basis, copy-paste from previous narrative without updating clinical status

For IDG meeting notes:
- Must include: date, all required disciplines present (or documented reason for absence), each patient discussed (status, concerns, plan changes), physician participation documented
- Must NOT include: blank discipline columns, generic "no changes" without clinical basis

Part 3: Upload knowledge files

In the Knowledge section of the project, click Upload files and add:

• CMS Hospice Conditions of Participation (PDF from cms.gov — search "42 CFR 418 hospice conditions of participation")
• CMS LCD for hospice eligibility (search "CMS LCD hospice" for your MAC's coverage determinations)
• Optional: 2-3 de-identified examples of your agency's approved recertification narratives (shows Claude your preferred style and format)

What you should see: Files listed in the Knowledge section. Claude will automatically reference these when generating documentation.

Part 4: Test the coaching functionality

Start a new conversation within the project. Paste a weak recertification narrative — something that's vague or missing key elements. Ask: "Can you review this recertification narrative and tell me what's missing or weak?"

You should receive specific, actionable coaching — not just "this could be better" but "this narrative doesn't include the mandatory eligibility statement, and the clinical indicators are vague ('patient is declining') without measurable markers like weight loss or PPS score."

Part 5: Test the drafting functionality

Ask Claude to draft a recertification narrative for a common scenario (e.g., end-stage CHF with NYHA Class IV, recent hospitalizations, weight loss). Verify that the output:

• Includes the 6-month eligibility statement
• References specific clinical indicators from the uploaded LCD
• Matches the style of any example narratives you uploaded
• Doesn't invent clinical details you didn't provide

Part 6: Share with colleagues

Go back to your Project settings and look for a sharing option. You can invite colleagues to the project (they need their own {{tool:Claude.plan}} accounts). Each person gets their own conversation thread within the shared project context — useful for team onboarding.

Real Example: Coaching a New Coordinator

Setup: Claude Project configured with CMS requirements and agency narrative examples.

Scenario: A new coordinator submits a recertification narrative: "Patient continues to decline. She is weak and not doing well. Family is concerned. Hospice care remains appropriate."

What Claude flags:

1. Missing eligibility statement — must state "prognosis of 6 months or less if the disease runs its normal course"
2. No diagnosis or staging information
3. No measurable clinical indicators (weight, function, symptoms)
4. "Not doing well" is not documentation — it needs specific clinical language
5. Missing functional status (can patient walk? Feed herself? PPS score?)

Claude's coaching response includes: The specific deficiencies, why each matters for CMS compliance, and a revised draft showing what a compliant version looks like with the same patient scenario.

Time saved for supervisor: Instead of reviewing and correcting 5-10 drafts per new coordinator, the coach catches and teaches the same lessons before the document reaches QA.

What to Do When It Breaks

• Claude forgets context between sessions → Always work within the Project, not in regular Claude chat — the Project maintains the instructions
• Uploaded documents aren't being referenced → Ask directly: "Based on the CMS documents I uploaded, what does the regulation say about [specific topic]?" — this prompts Claude to search the knowledge files
• Outputs are too generic despite instructions → Add more specificity to the Project Instructions; the more concrete your coaching standards, the more specific Claude's feedback
• Colleagues can't access the project → Confirm they have {{tool:Claude.plan}} and that you've added their email to the project sharing settings

Variations

• Simpler version: Skip the knowledge file uploads and use only the Project Instructions — you lose the specific LCD reference capability but still get the coaching structure
• Extended version: Add separate conversation threads within the project for different purposes — one for recertifications, one for IDG documentation, one for new coordinator onboarding questions

What to Do Next

• This week: Build the project and test it with 3 documentation scenarios — one strong, one weak, one borderline
• This month: Introduce it to one new coordinator as an onboarding tool and collect feedback
• Advanced: Work with your QA team to refine the coaching instructions based on the most common documentation deficiencies they see in your agency's records

Advanced guide for hospice coordinator professionals. Requires {{tool:Claude.plan}} subscription at {{tool:Claude.price}}.