Jacksonville is geographically the largest city by land area in the contiguous United States, and its hospice market reflects that scale. Duval County spans over 840 square miles, and agencies here face a legitimate logistical challenge: a nurse's day can include visits in dense urban neighborhoods near downtown, rural stretches in western Duval, and coastal communities in the Jacksonville Beaches area. Visit documentation in these varied settings has to hold up equally well regardless of setting.
Duval County agencies operate under First Coast Service Options (FCSO), which administers Medicare Part A and B for Florida, Puerto Rico, and the US Virgin Islands. First Coast has historically been active in hospice claim review, and agencies in the Jacksonville area are well-advised to maintain documentation that proactively addresses LCD criteria. Particularly for long-stay patients in benefit periods 3 and beyond where the face-to-face requirement applies.
Florida is also one of the most competitive hospice markets in the country. The state's large elderly population generates significant hospice volume, and agencies compete intensely for referrals from hospital discharge planners and case managers. Documentation quality. And the ability to demonstrate audit-defensibility. Can be a differentiator in physician and health system relationships.