Part 1: Appreciative Inquiry and the Certification Process... Imagine that!

Every hospice physician has experienced difficulties in assessing “gray” patients. These are the ones who, at admission, do not have a principal diagnosis or terminal story that leaps out from the record, although for many of these patients, the physician is able to answer “no” to the “would you be surprised if your patient dies within the next six months” question. 

  • Are these patients truly terminally ill?
  • Is a period of seeming stabilization sustainable?
  • Should these patients be evaluated for discharge due to extended prognosis?

 

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OIG Hospice Audit – Despite Extremely Low Error Rate, OIG Claims Significant Refund Liability on Basis of Extrapolation

The OIG clings to its tenuous position that, even with its concession that CMS will determine the overpayment amount, the hospice was overpaid “at least $447,467.”  This suggests OIG is driven to show Congress that it will continue to “come down hard” on hospices, even those with very low error rates.  

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The New IOM Report on Dying in America

The publication of the  Institute of Medicine's 2014 report  on Dying in America offers a significant opportunity to elevate the challenges of caring for people with advanced serious illness. Since hospice is the only Medicare benefit designed specifically for "the dying" and so many Americans are accessing hospice hours or days before they die, the issue of timely access to hospice care must be addressed.

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