Living a Good Life... at the End of Life

Transcription

1 Living a Good Life... at the End of Life 2014 Annual Conference April 15-16, 2014 Embassy Suites Lincoln, Nebraska

2 Nebraska s hospitals H 24/7 improving the health of individuals and the quality of life to entire communities and regions, making the state a better place to live, work and grow 24 hours a day 7 days a week days a year

3 A special thanks to the following agencies for supporting the 2014 annual conference. This program is supported in part by a grant from the Hospice Education Institute. This CNE is supported by an unrestricted educational grant and/or exhibits. This does not imply Nebraska Hospice and Palliative Care Association approval or endorsement of any product/medication. 1

4 Trade Show Exhibitors As of Feb. 25, 2014 Auxiliary of Gideons International Centering Corporation CIMRO of Nebraska Family Heritage Hospice Community Care of Nebraska Hospice Rx A Division of MedTrak Services Methodist Hospital Home Health & Hospice National HME Next Conversation Outcome Resources 2014 conference workgroup. Chair Diane Randolph, R.N., B.S.N. Methodist Hospice Marcia Cederdahl, R.N., CHPN AseraCare Hospice Vicki Coffin, R.N., CHPN Saint Elizabeth Regional Medical Center Palliative Care Carrie Healy, CMSW Fremont Area Medical Center Hospice Cindy Gage, R.N., CHPN Alegent Hospice Lori Molzer, R.N., CHPN AseraCare Hospice Mary Oliver, R.N., B.S.N. St. Joseph Villa Hospice Denice Schroeder, R.N., B.S.N., CHPPN, CHPN HealthConnect at Home Renee Siems AseraCare Hospice Tim Snyder, M.A. Hillcrest Hospice Ed Vandenberg, M.D. University of Nebraska Medical Center St. Joseph Villa Homecare & Hospice Jennifer Eurek, CSW NHPCA September Stone, R.N., M.S.N. NHPCA Kate Holman NHPCA Kathryn Nohl NHPCA Jodi White NHPCA 2

5 Embassy Suites 1040 P Street, Lincoln, NE embassysuiteslincoln.com X Directions to Embassy Suites Hotel from I-80: Take downtown exit onto I-180 south. Proceed to P Street, turn left, and go one block. Hotel is located on the corner of 10th and P Streets. Parking: City parking garages are located on the east and west side of Embassy Suites for a daily parking charge of $9. Hotel valet parking is available for $15 per day. Hotel Reservations Attendees are responsible for their own hotel reservations Call the Embassy Suites at EMBASSY to make your reservation. Request group code HP4. Make reservations before March 24, 2014, to guarantee room rate. Room Rate: $139* *Includes cook-to-order breakfast and evening reception 3

6 conference information. Nebraska Hospice and Palliative Care Association (NHPCA) Mission: A statewide partnership to improve the quality of life for all Nebraskans who have chronic conditions or are near the end of life and to support the various communities who care for them. Vision: No Nebraskan lives in pain or dies badly. Nebraskans with chronic or end-of-life conditions regardless of age, live their last months to their fullest, with their wishes expressed and respected, their pain and suffering alleviated, their fears and questions heard and addressed, their relational, spiritual, cultural, and financial needs met, with their loved ones around them and supported up to and following their death. Conference Purpose The goal of this conference is to improve end-of-life care and conditions across the state of Nebraska by providing education on end-of-life issues for physicians, nurses, social workers, advocates, administrators, and others working in the end-of-life field. Who Should Attend? This is a premier regional conference for everyone caring for patients and families with chronic illness or at the end of life. Attendees include physicians, nurses, therapists, social workers, administrators, and counselors. Cyber Station/Handouts The 2014 annual conference is paperless! The cyber station offers attendees a place to check and print handouts. Session handouts will be ed to registered attendees two weeks prior to the conference. Be sure to include your address on the registration form. ADA Requests If you need auxiliary aids or services identified in the Americans with Disabilities Act, please attach a description of requested accommodations to your registration form or call NHPCA at Photos NHPCA takes photographs during its events for use in Association media releases, newsletters, and other promotional materials, whether in print, electronic or other media including the NHPCA website and online social networking sites. By participating in this conference and other NHPCA events, you grant NHPCA the right to use your name and photograph for such purposes. Participant s Responsibilities Each Day Sign in each day at the registration table. In order to receive a certificate of completion, you must attend the entire presentation and turn in an evaluation. Continuing Education Credit This program is co-sponsored by the University of Nebraska Medical Center and the Nebraska Hospice and Palliative Care Association. Registrants can choose from hours of conference education sessions. The specific number of continuing education credit hours that have been requested from the appropriate licensing agencies are listed after each day s session descriptions. Registrants MUST PICK UP A CERTIFICATE OF ATTENDANCE at the end of each day. It is the responsibility of each registrant to retain his or her own certificate as verification of continuing education hours. Physicians, Nurse Practitioners, and Physician Assistants: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of Nebraska Medical Center, Center for Continuing Education, and the Nebraska Hospice and Palliative Care Association. The University of Nebraska Medical Center, Center for Continuing Education, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The University of Nebraska Medical Center, Center for Continuing Education, designates this live activity for a maximum of AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nurses, Social Workers, Licensed Mental Health Practitioners, and Nursing Home Administrators: Contact hours are listed after each day s session descriptions. Nursing peer-reviewed continuing education credit provided by Iowa Western Community College, Iowa Board of Nursing Provider #6. Peer review approved. 4

7 keynote speakers. Jennifer Kennedy, M.A., B.S.N., CHC, LNC Jennifer Kennedy is the Director of Regulatory and Compliance and Education Nurse Planner for the National Hospice and Palliative Care Organization. She has more than 27 years of experience as a leader and nurse in diverse health care settings in numerous areas of the United States and has worked in hospice care for more than 16 years. She has a B.S.N., a duel master s in case management and health counseling, and is currently working on her doctoral course work. Jennifer is a certified Health Care Compliance Professional, Legal Nurse Consultant, and peer nurse reviewer for Home Health Nurse Journal. Denise Mainquist, CISA, CPHIT Denise Mainquist has more than a decade of proven experience assessing and implementing information technology related projects, quality management systems, and standards and controls. She is a registered Medical Laboratory Technician, Certified Information Systems Auditor, a Certified Professional in Health Information Technology, Archer Technologies Certified Consultant, and was previously a Qualified Security Assessor for the Payment Card Industry. Denise has experience in HIPAA/HITECH assessments, defining and auditing IT controls, and has managed implementations of policies and procedures, document management/retention, and ISO 9001 quality management systems. Janet Bull, M.D., FAAHPM Janet Bull is Chief Medical Officer at Four Seasons and holds a consultant assistant professorship at Duke University Medical Center. She is a clinical instructor in medicine at UNC-CH Henderson Family Practice Residency Program. She is a Fellow of the Academy of Hospice and Palliative Medicine, board certified in hospice and palliative medicine, and a frequent speaker at both state and national meetings. She serves on the steering committee of the Palliative Care CoOperative Group, chairs the Membership Committee, and is currently an AAHPM board member. Janet has been an Associate Editor of PC-FACS since 2008 and has authored or co-authored several papers on palliative care and quality data reporting. Marcia Lattanzi Licht, LHD, R.N., LPC Marcia Lattanzi Licht is an internationally known educator, lecturing before professional groups and audiences throughout the U.S., Canada, Europe and Australia. She has appeared on the Today Show, MSNBC, and numerous other television and radio programs. A co-founder of TRU Community Hospice in Boulder, Colo., Marcia is a pioneering voice for end-of-life care. Marcia s numerous publications include The Hospice Choice and Coping with Public Tragedy. Marcia was awarded an honorary doctorate from the University of Colorado in 2005, the 1984 Winston Churchill Traveling Fellowship, the 2002 ADEC Educator Award, and NHPCO s 1995 Heart of Hospice. A licensed counselor, she maintains a private psychotherapy practice. 5

8 schedule at a glance. Tuesday, April 15 7:15 a.m.... Registration 7:15 a.m. - 3:45 p.m.....trade Show Open 8:00-8:15 a.m.... Welcome 8:15-8:45 a.m.... NHPCA Annual Meeting 8:45-10:00 a.m....general Session I Jennifer Kennedy, M.A., B.S.N., CHC, LNC Hospice: A View from Washington 9:00 a.m. - 3:45 p.m..... NHPCA Raffle Open 10:00-10:30 a.m. Break 10:30 a.m. - 12:00 p.m.... General Session II Denise Mainquist, CISA, CPHIT Confidentiality, Privacy and Security of Protected Health Information 12:00-1:00 p.m.... Lunch 1:00-2:00 p.m.... Concurrent Sessions [A1-A4] A1: Walking the Walk: Creative Tools for Transforming Compassion Fatigue A2: Bereavement Care: Nuts and Bolts A3: System Controls for Protecting Patient Information A4: The 72-Hour Admit 2:00-2:15 p.m.... Break 2:15-3:15 p.m.... Concurrent Sessions [B1-B4] B1: Regulatory Issues Affecting Hospice B2: Bereavement Interventions B3: Searching for Meaning in the World of Dementia B4: Communication Models and Tools for Co-Management of Hospice Patients Residing in Skilled Nursing and Assisted Living Facilities 3:15-3:30 p.m.... Break 3:30-3:45 p.m.... Announcements/Door Prizes 3:45-5:00 p.m.... General Session III Kay Glidden, M.S., and Beth Reynolds, B.S. Organizational Strategies for Compassion Fatigue Protection 5:00 p.m..... Adjourn/Evaluations/Certificates 5:30-6:30 p.m.... Reception 6:30 p.m.... Banquet 6

9 schedule at a glance. Wednesday, April 16 7:15 a.m.... Registration 7:15 a.m. - 3:30 p.m.....trade Show Open 7:15 a.m. - 3:00 p.m..... NHPCA Raffle Open 8:00-8:15 a.m.... Welcome 8:15-10:15 a.m.... General Session IV Janet Bull, M.D., FAAHPM Debility, Failure to Thrive, and Other Diagnostic Dilemmas for Hospice Patients; and Prognostication 10:15-10:45 a.m.... Break 10:45-11:45 a.m.... Concurrent Sessions [C1-C4] C1: Creating and Sustaining a Zone of Helpfulness: Boundaries in Hospice Care C2: Interventions in Working with the Bereaved C3: Palliative Care and Dementia C4: Nutrition Needs at the End of Life: Is Food a Four-Letter Word or Love Made Visible? 11:45 a.m. - 12:45 p.m.... Lunch 12:45-1:45 p.m.... Concurrent Sessions [D1-D4] D1: Rural Issues in Hospice Care: Managing Our Challenges Maximizing Our Strengths and Opportunities D2: Pain and Symptom Management: A Pharmacy Perspective D3: How We Die in Nebraska: Updates and Alerts D4: Best Practices for Billing and Coding in Hospice/Palliative Care 1:45-2:00 p.m.... Break 2:00-3:00 p.m.... Concurrent Sessions [E1-E4] E1: Palliative Wound Care E2: Bed Bugs: Recognize, Prevent and Manage Infestations E3: Pediatric Hospice E4: Medicaid Managed Long-Term Services and Supports 3:00-3:15 p.m.... Break 3:15-3:30 p.m.... Announcements/Door Prizes/Raffle Prizes 3:30-4:45 p.m.... General Session V Marcia Lattanzi Licht, LHD, R.N., LPC Facing the Next Challenge 4:45 p.m..... Adjourn/Evaluations/Certificates For your personal comfort, we suggest you dress in layers to accommodate variable room temperatures. 7

10 tuesday. april 15. schedule details. 7:15 a.m Registration Opens 7:15 a.m. - 3:45 p.m.... Trade Show Open 8:00-8:15 a.m Welcome 8:15-8:45 a.m NHPCA Annual Meeting 8:45-10:00 a.m General Session I Hospice: A View from Washington Jennifer Kennedy, M.A., B.S.N., CHC, LNC Director, Regulatory and Compliance, National Hospice and Palliative Care Organization Alexandria, Va. This session will provide a view of the national environment as it relates to health care and hospice. The presentation will look at the congressional and regulatory issues related to federally funded hospice care and look at the future of hospice and palliative care. Explain the national environment and what is driving the scrutiny on hospice. Diagram current hospice legislative and regulatory issues. Discuss the future of end-of-life care including hospice and palliative care. 9:00 a.m. - 3:45 p.m.... NHPCA Raffle Open 10:00-10:30 a.m Break 10:30 a.m. - 12:00 p.m.. General Session ll Confidentiality, Privacy and Security of Protected Health Information Denise Mainquist, CISA, CPHIT President, ITPAC Consulting, LLC The purpose of this activity is to enable the learner to understand the difference between confidentiality, privacy, and security of protected health information. Practical and affordable steps to protect PHI and prevent a breach will be provided, as well as the basics for identifying a breach and the reporting requirements. Identify the difference between privacy, confidentiality, and security of confidential and sensitive patient information. Examine practical protections of protected health information. Discuss reporting breaches of protected health information. 8 12:00-1:00 p.m Lunch 1:00-2:00 p.m Concurrent Sessions [A1-A4] A1: Walking the Walk: Creative Tools for Transforming Compassion Fatigue Kay Glidden, M.S. Compassion Fatigue Specialist/Trainer Kearney, Neb. Beth Reynolds, B.S. Compassion Fatigue Instructor Kearney, Neb. This interactive session will offer information regarding compassion fatigue, vicarious trauma, moral distress, and burnout. Participants will complete a symptom checklist, evaluate their self-care, and identify triggers and strategies to transform compassion fatigue. Examine compassion fatigue and its components. Interpret warning signs and symptoms of compassion fatigue. Employ tools and resources to transform compassion fatigue. A2: Bereavement Care: Nuts and Bolts Jea Theis, LMHP, LCSW, LMSW Patient and Family Services Coordinator/Bereavement Coordinator, Hillcrest Hospice Care Bellevue, Neb. This session will enable the learner to gain a broad knowledge of human attachment as it contributes to the grief experience. The training is geared toward assisting all disciplines in better understanding and assisting families as they navigate the end-of-life journey. The presentation will also focus on how hospice organizations can develop an effective bereavement program. Describe human attachment as it contributes to the grief experience and how background factors contribute to resiliency and risk in patient and family systems. Discover the inter-disciplinary role as it relates to the patient and family grieving process. Develop an awareness of innovative interventions and collaborations within the hospice agency and community. Discuss quality improvement measures that can be incorporated to gauge the effectiveness of the program.

11 tuesday. april 15. schedule details. A3: System Controls for Protecting Patient Information Denise Mainquist, CISA, CPHIT President, ITPAC Consulting, LLC The purpose of this activity is to enable the learner to implement appropriate protections on mobile devices and system access of protected health information. Attendees will also learn to protect their own login credentials and mobile devices to avoid inappropriate and fraudulent access by others that could affect an employee s own identity, reputation and licenses. Recognize how to establish secure passwords or multifactor authentication. Describe the risks of sharing login credentials and the importance of system time outs. Identify the risks and rewards of mobile devices. A4: The 72-Hour Admit Jackie Bates, R.N., CHPN Owner, The Next Conversation Bennet, Neb. One of the most conflicting referrals to end-of-life care is the 72-hour admit. This situation may even bring more controversy than death itself. Late admissions are common to all hospice teams and affect every discipline on the team. This presentation will address the professional challenges during the 72-hour admit. Describe two effects on the hospice team (one negative, one positive) during the 72-hour admit. Identify two categories or guidelines detailing eligibility for a referral to end-of-life care. Express two opportunities in your career to counter late admissions and a personal barrier to having an end-of-life conversation. 2:00-2:15 p.m Break 2:15-3:15 p.m Concurrent Sessions [B1-B4] B1: Regulatory Issues Affecting Hospice Jennifer Kennedy, M.A., B.S.N., CHC, LNC Director, Regulatory and Compliance, National Hospice and Palliative Care Organization Alexandria, Va. Are you up to date about hospice regulatory issues and health care reform? This session will highlight important regulatory issues and describe health care reform s impact on the hospice industry. Participants will receive cutting-edge information about what is happening within the federal government, CMS and other federal entities that affect hospice care. Identify the current hot issues in the hospice industry and how they affect hospice providers and the hospice industry as a whole. Describe the climate within CMS and the federal government about hospice care. Describe where to locate available resources and receive answers to outstanding questions. B2: Bereavement Interventions Jea Theis, LMHP, LCSW, LMSW Patient and Family Services Coordinator/Bereavement Coordinator, Hillcrest Hospice Care Bellevue, Neb. The purpose of this activity is to enable the learner to gain a broader knowledge and skill-base for intervening with grieving individuals, families and groups. The presentation will focus on building rapport and identifying factors of resilience and risk. Participants will be invited to explore and apply some basic individual interventions, as well as group and family interventions such as activities and art therapy. Identify factors and techniques in building rapport and criteria for establishing bereavement needs and level of risk. Describe the theoretical underpinning and application of four individual grief intervention approaches. Identify dynamics that can occur within family and other groups of grieving individuals and how to use interventions to increase resilience and coping of clients and client systems. B3: Searching for Meaning in the World of Dementia Geri Hepp, M.A., CSW Hospice Social Worker, AseraCare Hospice Sharon Schuster Hospice Chaplain, AseraCare Hospice The purpose of this activity is to enable the learner to discover how spiritual care and the use of validation can reduce anxiety and stress, enhance dignity, and increase happiness and contentment for people with dementia. This activity will provide tools to help improve relationships between people with dementia and their families and caregivers. (continued on next page) 9

12 tuesday. april 15. schedule details. Explain the principles of validation and the four stages of resolution. Identify how persons with dementia respond to songs, prayers, and religious symbols and rituals. Define the benefits of spiritual care and validation to persons with dementia, their families and caregivers. B4: Communication Models and Tools for Co Management of Hospice Patients Residing in Skilled Nursing and Assisted Living Facilities Nicole Dyer, M.S.N., APRN, ACNP-BC Advanced Practice Registered Nurse, Palliative Care and Hospice, Prime Home Care, LLC, Compassionate Care Hospice Omaha, Neb. Many patients receiving hospice benefits reside in skilled nursing and assisted living facilities. Communication breakdowns between hospice and facility staff can result in misunderstandings about responsibilities and inadequate symptom management. This session will provide strategies to overcome these barriers to collaboration. Explain barriers to collaboration between agency hospice staff and skilled/assisted living staff. Evaluate communication models for co-management of patients including patient hand-off. Apply communication model to hospice-related patient symptoms using case study discussion. Participants will be given hands-on tools that can be implemented in the workplace. Examine compassion fatigue, vicarious trauma, moral distress, and burnout. Examine organizational strategies that improve compassion fatigue protection. Employ tools and resources to transform compassion fatigue on an organizational level. 5:00 p.m Adjourn/Evaluations/ Certificates 5:30-6:30 p.m Reception 6:30 p.m Banquet 6.0 contact hours awarded. Nursing peer-reviewed continuing education credit provided by Iowa Western Community College, Iowa Board of Nursing Provider #6. Peer review approved. This program meets the criteria for 6.0 hours of an approved continuing education program for certified social workers, certified master social workers, and licensed mental health practitioners. This program meets the criteria for 6.0 hours of an approved continuing education program for Nebraska nursing home administrators. 3:15-3:30 p.m Break 3:30-3:45 p.m Announcements/Door Prizes 3:45-5:00 p.m General Session III Organizational Strategies for Compassion Fatigue Protection Kay Glidden, M.S. Compassion Fatigue Specialist/Trainer Kearney, Neb. Beth Reynolds, B.S. Compassion Fatigue Instructor Kearney, Neb. Is your organization suffering from low morale, high turnover, negativity, absenteeism, or high costs to replace employees? This session will address ideas your organization can use to actively prevent and protect staff from stress and compassion fatigue. 10

13 wednesday. april 16. schedule details. 7:15 a.m Registration Opens 7:15 a.m. - 3:30 p.m.... Trade Show Open 7:15 a.m. - 3:00 p.m.... NHPCA Raffle Open 8:00-8:15 a.m Welcome 8:15-10:15 a.m General Session IV Debility, Failure to Thrive, and Other Diagnostic Dilemmas for Hospice Patients; and Prognostication Janet Bull, M.D., FAAHPM Chief Medical Officer, Four Seasons Consultant, Duke University Medical Center Teaching Faculty, University of North Carolina Arden, N.C. In the final rule released in August 2013, CMS clarified that ill-defined diagnoses such as debility and failure to thrive are not acceptable as principal diagnoses for hospice patients. Strategies for determining coverage and certification of these frail individuals will be discussed. Describe hospice trends and the CMS concerns around current diagnoses and covered hospice services. Describe how to diagnose and certify patients without using debility, failure to thrive, and other ill-defined primary diagnoses. Discuss coding discrepancies between ICD-9 and the Medicare Claims Manual, and discuss related and unrelated charges according to CMS guidelines and the use of secondary diagnoses. Prognostication is both an art and a science, and learning the necessary skills to predict life expectancy is vitally important to determining hospice eligibility. This presentation will discuss the four different pathways leading to death and the factors that contribute to decline. It will also examine the different prognostication tools that are available to use in decision making. Describe the four common pathways to death and the common denominators which are universal despite diagnosis. Demonstrate improved prognostication skills by disease categories. Explain the importance in documenting prognosis for recertification notes and initial narratives for hospice and the use of biomarkers and prognostication tools. 10:15-10:45 a.m Break 10:45-11:45 a.m Concurrent Sessions [C1-C4] C1: Creating and Sustaining a Zone of Helpfulness: Boundaries in Hospice Care Linda Rock, B.A. Consultant, Prairie Haven Hospice Past Executive Director, Prairie Haven Hospice Scottsbluff, Neb. This session will explain the importance of boundaries in protecting the hospice patient and family. It will also describe the importance of protecting the care providers and organization to create and maintain a zone of helpfulness. Describe how the development of boundary setting assists in providing patient/family-centered care and protection of self as well as the organization. Explain three specific boundary violations. Identify how to establish professional boundaries within your work environment. C2: Interventions in Working with the Bereaved Nancy Gabelman, M.S.W., LIMHP Bereavement Coordinator, AseraCare Hospice This session will explore the counseling process of working with bereaved individuals. It will review the needs of the bereaved and discuss how the therapeutic relationship can be used as a tool in helping them. The session will also provide specific interventions and techniques to help the bereaved cope with grief feelings. Identify what is most important for the bereaved to understand about normal and healthy grieving. Explain how to help the bereaved tell their story in a way that is meaningful and helpful to them. Recognize what type of support the bereaved need from staff. C3: Palliative Care and Dementia Mary Harris Christensen, APRN Instructor, UNMC College of Nursing Lincoln Campus Nurse Practitioner, Private Practice The unique situation of late-stage dementia care requires that we adapt our established concepts of palliative care to each individual situation in order (continued on next page) 11

14 wednesday. april 16. schedule details. for the patient, family, and professionals to prepare for the transitional care of end of life. This session will focus on establishing a patient-centered approach to end-of-life care to all patients, particularly those with dementia. Identify the usual indicators of end-of-life trajectory. Explain the quality of pain management in people with dementia. Describe the use of palliative care in people with dementia. C4: Nutrition Needs at the End of Life: Is Food a Four-Letter Word or Love Made Visible? Helen Owen, M.S., R.D., LMNT Clinical Dietitian Retired, Alegent Health Omaha, Neb. This presentation will focus on the role of nutrition at the end of life. Participants will receive practical suggestions for presenting appropriate feedings and strategies to deal with family concerns as death approaches. Explain nutrition and hydration needs at the end of life. Formulate practical suggestions for use of food in palliative care. Develop strategies to deal with family response to withdrawing nutrition at the end of life. 11:45 a.m. - 12:45 p.m.... Lunch 12:45-1:45 p.m Concurrent Sessions [D1-D4] D1: Rural Issues in Hospice Care: Managing Our Challenges Maximizing Our Strengths and Opportunities Linda Rock, B.A. Consultant, Prairie Haven Hospice Past Executive Director, Prairie Haven Hospice Scottsbluff, Neb. Sandy Kuhlman, R.N. Executive Director, Hospice Services Inc. Phillipsburg, Kan. The purpose of this activity is to enable the learner to understand the unique challenges rural hospice providers face. Attendees will learn to maximize strengths and opportunities so that services can be sustained in the face of increasing scrutiny, decreasing reimbursement, and regulatory and compliance requirements. Identify the unique challenges, barriers to care, and operations that hospices in rural areas face. Identify 12 the strengths and opportunities of rural hospice programs. Create a plan for sustaining services into the future with increasing regulatory/compliance requirements and decreasing reimbursement. D2: Pain and Symptom Management: A Pharmacy Perspective Kristin McNaughton, Pharm.D. Pharmacist, Saint Elizabeth Regional Medical Center Jenna Preusker, Pharm.D. Pharmacist, Saint Elizabeth Regional Medical Center The purpose of this activity is to enable the learner to have a general overview of common medications used in management of symptoms associated with end-of-life care from a pharmacy perspective. Participants will be able to understand the role of pharmacists on the palliative care team and identify opportunities for pharmacists to assist in interdisciplinary management. Discover common end-of-life gastrointestinal symptoms and pharmacologic management strategies. Discuss other common end-of-life symptoms and pharmacologic management strategies. Evaluate the role of the pharmacist in hospice and palliative care. D3: How We Die in Nebraska: Updates and Alerts Helen S. Chapple, Ph.D., R.N., M.S.N., M.A., CT Assistant Professor, Creighton University Omaha, Neb. Often we are so focused on caring for the patients and families before us that we don t attend to a statewide picture of dying. Specific state policies define the background of our work, and demographics such as the place of death tell a story about the quality of the dying experience that is available to us and our neighbors. This session will explore advance care planning, dying and death, and death investigation in Nebraska. Define how population demographics such as the place of death relate to the quality of the dying experience. Describe how Nebraska state policies influence dying and death for state residents and how these policies compare to other states. Name one implication of demographics and/or state policies that could cause concern to frail persons in Nebraska.

15 wednesday. april 16. schedule details. D4: Best Practices for Billing and Coding in Hospice/Palliative Care Janet Bull, M.D., FAAHPM Chief Medical Officer, Four Seasons Consultant, Duke University Medical Center Teaching Faculty, University of North Carolina Arden, N.C. This presentation will equip the learner with best practices regarding billing and coding. It will discuss the triggers for audits, the difference between billing under complexity versus time, the use of prolonged service codes, and nuances related to hospice and palliative care. This presentation will discuss some of the common pitfalls that occur and discuss why it s important to have a compliance program. Understand the increased scrutiny from OIG, what triggers audits, and how to best prepare. Understand the nuts and bolts of proper coding, time versus complexity billing, extender codes, and nuances specific to palliative care. Discuss the importance and elements of a compliance program. 1:45-2:00 p.m Break 2:00-3:00 p.m Concurrent Sessions [E1-E4] E1: Palliative Wound Care Andrea Porter, B.S.N., R.N., CWON Wound and Ostomy Nurse, Saint Elizabeth Regional Medical Center Esther Rathjen, APRN CCNS Burn Center Clinical Nurse Specialist, Saint Elizabeth Regional Medical Center The purpose of this activity is to enable the learner to assist palliative and hospice patients with basic aspects of wound care. This session will identify tips for relieving pain with dressing changes, cost effective dressing selection, and challenges associated with wound care in the palliative and hospice setting. This session will also provide tips for educating patients and families about the wound care program and goals of therapy. Describe current and budget-friendly wound management at the end of life. Identify in the longterm care setting where the hospice client resides and how to align with treatment (cure) versus palliative care. Explain how to help with the challenges of care such as odor, drainage and dressing changes. E2: Bed Bugs: Recognize, Prevent and Manage Infestations Barbara P. Ogg, M.S., Ph.D. UNL Extension Educator, Entomologist, UNL Extension in Lancaster County This program will enable the learner to identify bed bugs including fecal spots and hiding places, bites, and human responses to bites. Participants will learn what steps to take to prevent bed bugs from coming into or spreading throughout a residence and learn best management practices for eliminating bed bugs. Recognize bed bugs and their signs. Identify methods to monitor and prevent the spread of bed bugs. List appropriate action steps when confronted with a bed bug infestation. E3: Pediatric Hospice Susan M. Coughlin, M.S., B.S.N., R.N. R.N. Case Manager, Hand in Hand/Palliative Care, Children s Hospital and Medical Center Omaha, Neb. This session will focus on pediatric hospice in Nebraska. Objective data from hospices regarding pediatric hospice referrals will be reviewed and discussed. Participants will also receive various methods to overcome barriers and provide support for pediatric hospice referrals in greater Nebraska. Summarize the results of Nebraska hospice survey. Paraphrase the results of Children s Hospital and Medical Center PI Project: Transition to end-of-life care. Discuss various methods for providing support for pediatric hospice referrals in greater Nebraska. E4: Medicaid Managed Long-Term Services and Supports Heather Leschinsky, B.A. Administrator, Medicaid and Long-Term Care, Nebraska Department of Health and Human Services Julie Docter, B.S. Program Specialist, Medicaid and Long-Term Care Division, Nebraska Department of Health and Human Services (continued on next page) 13

16 wednesday. april 16. schedule details. Nebraska Medicaid is planning to implement a Managed Long-Term Services and Supports program. CMS has issued guidance for states which outline essential elements that Medicaid programs will need to consider when requesting federal authority for MLTSS programs. Nebraska Medicaid is using this guidance in the design, development, and implementation of the MLTSS program. This presentation will provide an overview of the guidance and discuss how the essential elements are being incorporated into the Nebraska Medicaid MLTSS program. Describe the Managed Long-Term Services and Supports program. Explain Nebraska Medicaid s role in developing and implementing the MLTSS program. Discuss how MLTSS in Nebraska will impact providers of Medicaid long-term care services. 3:00-3:15 p.m Break 3:15-3:30 p.m Announcements/ Door Prizes/Raffle Prizes 3:30-4:45 p.m General Session V Facing the Next Challenge Marcia Lattanzi Licht, LHD, R.N., LPC Psychotherapist, Educator Boulder, Colo. The changing hospice and palliative care world reflects the larger changes in health care and growing economic pressures. Practitioners continue to struggle with constant regulatory and financial realities. This reflective session will focus on ways teams and individuals can best respond to these pressures. Reclaiming and rediscovering the rewards of hospice and palliative care work is an important element of maintaining satisfaction in the face of challenges. Describe ways to meet changes and challenges personally and organizationally. Outline ways to enhance support and resilience in the team and as individuals. Discuss ways to maximize the rewards of hospice and palliative care work contact hours awarded. Nursing peer-reviewed continuing education credit provided by Iowa Western Community College, Iowa Board of Nursing Provider #6. Peer review approved. This program meets the criteria for 6.25 hours of an approved continuing education program for certified social workers, certified master social workers, and licensed mental health practitioners. This program meets the criteria for 6.25 hours of an approved continuing education program for Nebraska nursing home administrators awards. Shining Star Award The Shining Star Award recognizes an individual, group or organization that has illustrated outstanding leadership in the promotion of end-of-life services, raised awareness of or educated others on end-of-life issues, developed a new program, or developed or completed outstanding work in an end-of-life coalition. Spirit of Hospice Award The Spirit of Hospice Award recognizes true commitment and outstanding dedication to the hospice philosophy of care. Nominees should have promoted quality hospice care over the last year. They should display openness to the needs of all they have cared for, reverencing the dignity of all areas of diversity. Outstanding Hospice Volunteer Recognition Honors exemplary volunteers from Nebraska s hospice programs. Nominations must be submitted by March 14, Award recipients will be recognized at the awards banquet on April 15, Go to nehospice.org for more details. 14

17 1 Registration Form Living a Good Life...at the End of Life NHPCA Annual Conference April 15-16, 2014 Name Title Credentials Organization Address City, State, Zip Phone Fax If you have a disability that warrants special requirements, please attach a written description of your needs. Please note any dietary restrictions or requests. Please complete all three sections below: 2 3 Select your choice of concurrent sessions: Tuesday, April 15 Wednesday, April 16 1:00 p.m. A1 A2 A3 A4 10:45 a.m. C1 C2 C3 C4 2:15 p.m. B1 B2 B3 B4 12:45 p.m. D1 D2 D3 D4 2:00 p.m. E1 E2 E3 E4 Select which continuing education you require: Physician/NP/PA Nursing Nursing Home Administrator Social Work/LMHP Circle the appropriate rate: Member Early Bird Rate by March 21 Member Rate after March 21 Non-Member Early Bird Rate by March 21 Non-Member Rate after March 21 Total Full Conference Registration Both Days: April $ $ $ $ Daily Registration Tuesday, April 15 $ $ $ $ Daily Registration Wednesday, April 16 $ $ $ $ Awards Banquet/Dinner Tuesday, April 15 $ $ $ $ Total Additional registration information and the cancellation policy are provided on the back side of this form. Send completed form and payment to: NHPCA,1200 Libra Dr Ste 100, Lincoln NE or register online at nehospice.org

18 Registration Information Full Conference Registration: Includes both days of education (April 15 and 16), breaks, lunches, admission to the trade show, raffle, and annual meeting. Daily Registration: Registration on a per-day basis for Tuesday or Wednesday. Daily registration includes all education sessions, lunch, breaks, admission to the trade show, and raffle for the day. Tuesday registration includes the annual meeting. Awards Banquet/Dinner Tickets: Tickets must be purchased separately to attend the Tuesday evening awards banquet NOT included in full conference registration or daily registration. Cancellation Policy All cancellation requests must be submitted in writing. A $50 processing fee will apply to all cancellations. Cancellations on or before April 1, 2014, will receive a full refund less the processing fee. No refunds will be given on cancellations postmarked after April 1, Substitutions are welcome; please submit your request in writing. NHPCA reserves the right to substitute faculty or to cancel or reschedule sessions due to unforeseen circumstances. If the conference must be canceled, registrants will receive full credits or refunds of the paid registration fees. No refunds can be made for lodging, airfare, or any other expense related to attending the conference. NHPCA Raffle Contribution Form YES, I would like to donate an item or package for the raffle. Please submit a form for each item or package donation. Provide name of contributing person or agency/organization as it should appear on recognition: Contact Name Organization Name Address City, State, Zip Phone Fair Market Value of Item or Package: $ Provide a detailed description of the item or package. Attach a description if more space is needed. Donations should be delivered to NHPCA by April 7 or brought to the conference registration desk on Tuesday, April 15. The Nebraska Hospice and Palliative Care Association is an IRS-recognized 501(c)3 non-profit organization. Your contribution to NHPCA may be tax deductible. To Donate a Raffle Prize: Complete the contribution form and mail or fax to NHPCA. To Participate in the Raffle: See the directions on the following page. For questions, contact Kathryn Nohl at the Nebraska Hospice and Palliative Care Association 1200 Libra Dr Ste 100, Lincoln NE phone fax KathrynN@nehca.org

19 awards banquet and entertainment. trade show. Tuesday, April 15 5:30 p.m. Reception 6:30 p.m. Awards Banquet and Entertainment Award Winner Recognition Shining Star Award Spirit of Hospice Award Outstanding Volunteer Recognition Entertainment Shine Your Light: A Song of Caring by Marcia Lattanzi Licht Caring for others means directing toward them the light of attention and hope. Relationships that focus on others in difficult times of their lives offer us strength and kindle our own spark. Tuesday, April 15 7:15 a.m. to 3:45 p.m. Wednesday, April 16 7:15 a.m. to 3:30 p.m. Registered conference attendees are invited to the Trade Show. The Trade Show offers a great opportunity to visit with exhibitors and become better acquainted with their variety of products, services and equipment. Trade Show Door Prizes Sign up at participating booths to win a variety of exciting prizes donated by exhibitors. Win Door Prizes! Door prizes will be given away during the NHPCA Conference Trade Show. Sign up at participating booths! nhpca annual raffle. During the conference, plan to visit the NHPCA Annual Raffle. Winners can take home a variety of fun items and packages! Funds raised through the raffle support scholarships for hospice professionals in Nebraska. To Participate in the Raffle: Raffle items will be displayed at the raffle booth in the Trade Show from 9 a.m. to 3:45 p.m. on Tuesday, April 15, and 7:15 a.m. to 3 p.m. on Wednesday, April 16. Stop by to see the prizes that you can win! Raffle tickets can be purchased from any conference workgroup member, board member, or at the raffle booth. To Donate a Raffle Prize: Donations of single items and packages are needed to make this event a success. To donate, complete the NHPCA raffle contribution form. Donations should be delivered to NHPCA by April 7 or brought to the conference registration desk on Tuesday, April 15. Additional details are available at nehospice.org.

20 1200 LIBRA DR STE 100 LINCOLN NE Living a Good Life... at the End of Life 2014 Annual Conference, April 15-16, Lincoln, NE nehospice.org nebraska nursing facility association nebraska assisted living association nebraska health care learning center NHPCA is proud to be part of the Nebraska Health Care Association Family 1200 Libra Drive, Suite 100 Lincoln, NE Phone Fax nehca.org licensed practical nurse association of nebraska nebraska hospice & palliative care association nebraska health care foundation