Through collaborative thinking, the team chooses innovative processes that are in alignment with both the strengths identified in Discovery and the imagined hopes of the future (Dream).Read More
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?
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.Read More
What does hospice have in common with political campaigns besides elections? Unfortunately, more than you'd think. It's not to late to reverse course and return to the days when journalists, patients/families, and referring physicians were promoting the benefits of hospice. Our colleague Kathy Brandt explores these similarities and ways each hospice can work to repair the reputation of hospice.Read More
The Medicare Hospice Benefit has always defined the terminal illness, not as a single diagnosis, but as the interplay of conditions that together cause an individual to have a prognosis of 6 months or less. At this point, the proposed definition is open for comments. However, my guess is that in the final determination there may well be a clear differentiation between the definition of ‘terminal illness’ and that of the ‘principle/hospice-qualifying diagnosis’ to better underscore the prognostic implication and comprehensive nature of the former.Read More
Proactively preparing for medical review positions your hospice for the best possible outcome in the event you receive IMPACT-related scrutiny, Additional Development Requests (ADRs) or become the target of any audits or investigations related to patient eligibility.Read More
The passage of the 2014 IMPACT Act will bring more survey's to hospices. In this first of two blog posts, Joy Barry details what hospices need to do now to prepare for more frequent surveys of a hospice’s compliance with the Medicare Conditions of Participation (CoPs).Read More
Am I a party pooper? A Debbie Downer? You can decide, but I don't think the hospice provisions in the Impact Act of 2014 are going to do much to increase transparency, sort out the "good" hospices from the "bad," or, sadly, improve the quality of care provided by hospices. Let me explain...Read More
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.Read More
By now you have hopefully heard about the changes regarding the hospice Notice of Election (NOE), Notice of Termination/Revocation (NOTR), and processes for identifying/changing the attending physician that take effect October 1, 2014. This blog post details these changes and identifies best practices to comply with the changes. At the conclusion of this post is a downloadable PDF that you can share with everyone who needs this information.Read More