Determining Hospice Eligibility and Relatedness

Size: px
Start display at page:

Download "Determining Hospice Eligibility and Relatedness"

Transcription

1 Determining Hospice Eligibility and Relatedness Jennifer Kennedy, MA, BSN, RN, CHC National Hospice and Palliative Care Organization September 2015

2 Learning objectives Review of federal hospice regulations Hospice physician role Attending physician role Interdisciplinary team role Assessment of Hospice of Central PA s: Determination of eligibility and relatedness process Identification of compliance risks and areas for improvement Identification of resources National Hospice and Palliative Care Organization,

3 418.3 Definitions The Regulation Terminally ill means that the individual has a medical prognosis that his or her life expectancy is 6 months or less if the illness runs its normal course. National Hospice and Palliative Care Organization,

4 Palliative Goals of Care The person beginning hospice care, or his or her representative, needs to understand that his or her illness is no longer responding to medical interventions to cure or slow the progression of disease and then must choose to stop further curative attempts while palliative care continues and intensifies, as needed, for continued symptom management. (Italics added) Medicare Program; FY 2014 Hospice Wage Index and Payment Rate Update; Hospice Quality Reporting Requirements; and Updates on Payment Reform, 78 Federal Register 152 (7 August 2013), p National Hospice and Palliative Care Organization,

5 Terminal Prognosis National Hospice and Palliative Care Organization,

6 Determining Terminal Prognosis Life expectancy of 6 months or less. Is this someone at high risk of death? General indicators of poor prognosis. Disease-specific indicators of poor prognosis, including the local coverage determinations (LCD). National Hospice and Palliative Care Organization,

7 Would you be surprised if this patient died within the next 6 months? National Hospice and Palliative Care Organization,

8 General Indicators Performance status Global measure of patient s functional capacity Karnofsky Performance Status (KPS) Palliative Performance Scale (PPS) Decline in cognitive/physical function (KPS/PPS <50%) National Hospice and Palliative Care Organization,

9 General Indicators, cont. Recurrent serious infections Signs of severe malnutrition Disease-related weight loss >10% in last 6 months Albumin <2.5 gm/dl Prolonged loss of appetite, little oral intake Multiple non-healing pressure ulcer, stage 3-4 Multiple comorbidities (CHF, COPD, ESRD, etc.) National Hospice and Palliative Care Organization,

10 Clinical Case Mrs. Smith is a 95 year old woman who moved in with her daughter 1 year ago because she could no longer live alone. Her daughter calls the hospice today because, She s just stopped eating. Mrs. Smith does not see a physician but has been to the emergency room twice in the last 6 weeks because of confusion; once, she was admitted with a urinary tract infection. Since then, she has been weaker and spends most of her day in bed or the recliner. The admission nurse examines her and finds she is very thin and frail, cannot stand or walk without assistance, and has a stage 2 pressure ulcer on her sacrum and another on her left heel. National Hospice and Palliative Care Organization,

11 Documentation of Prognosis Paint the picture narrative is necessary! Remember Function, Cognition, Nutrition Use objective LCD data when it s available If the patient doesn t meet the LCD, describe why they are terminally ill anyway; often more than one diagnosis is contributing to the prognosis National Hospice and Palliative Care Organization,

12 Terminal Diagnosis and Related Diagnoses/ Conditions National Hospice and Palliative Care Organization,

13 Determining the Principal Diagnosis The principal diagnosis should reflect the condition to be chiefly responsible for the services provided. The principal diagnosis reported on the hospice claim form should be determined by the hospice as the diagnosis most contributory to the terminal prognosis. It is often not a single diagnosis that represents the terminal prognosis of the patient, but the combined effect of several conditions that makes the patient s condition terminal. 78 Federal Register 152 (7 August 2013), pp.48236, National Hospice and Palliative Care Organization,

14 Determining the Principal Diagnosis The principal diagnosis should be the condition determined by the certifying hospice physician(s) as the diagnosis most contributory to the terminal decline. Certifying physicians should use their best clinical judgment in determining the principal diagnosis and related conditions, based on the hospice comprehensive assessment and review of any and all other clinical documentation. 78 Federal Register 152 (7 August 2013), p.48240, National Hospice and Palliative Care Organization,

15 What is contributory? The relationship between diagnoses may change over time How does a patient with ESRD on dialysis with End-stage heart failure look when referred 5 months before death? How does the same patient look when referred 5 weeks before death? Or 5 days before death? National Hospice and Palliative Care Organization,

16 Most Contributory Diagnosis LCDs: not the only diagnoses that can or should be used to enroll patients in hospice care Look up diagnoses in the coding manual! This may be difficult for some providers to accept as they may not understand how malnutrition, anemia, or depression, for example, could be reported as a principal hospice diagnosis. 78 Federal Register 152 (7 August 2013), pp National Hospice and Palliative Care Organization,

17 Determining the Terminal Diagnosis We are clarifying that the certifying physician would select the condition he or she feels is most contributory to the terminal prognosis. this principal diagnosis, along with the other related diagnoses, would be included on the hospice claim. Having all related conditions reported on the hospice claim form will ensure that hospices are aware of and provide all of the expert care, including services, drugs, supplies, and DME, that a Medicare hospice beneficiary requires as he or she approaches end-of-life. 78 Federal Register 152 (7 August 2013), p National Hospice and Palliative Care Organization,

18 Determining the Terminal Diagnosis Malnutrition, dysphagia, and decreased functional status and muscle weakness.... There are ICD-9-CM codes for all of the clinical presentations listed above. eligibility should always have been based on the terminal prognosis of the patient, and this prognosis would typically involve more than one diagnosis. 78 Federal Register 152 (7 August 2013), p National Hospice and Palliative Care Organization,

19 Related Conditions The principal diagnosis should be the condition determined by the certifying hospice physician(s) as the diagnosis most contributory to the terminal decline. Certifying physicians should use their best clinical judgment in determining the principal diagnosis and related conditions, based on the hospice comprehensive assessment and review of any and all other clinical documentation. 78 Federal Register 152 (7 August 2013), p.48240, National Hospice and Palliative Care Organization,

20 Co-morbidities The presence of diseases, the severity of which is likely to contribute to a life expectancy of six months or less, should be considered in determining hospice eligibility. Chronic obstructive pulmonary disease Congestive heart failure Ischemic heart disease Diabetes mellitus Neurologic disease (CVA, ALS, MS, Parkinson s) Renal failure Liver Disease Neoplasia Acquired immune deficiency syndrome Dementia Clinically pertinent related to terminal prognosis National Hospice and Palliative Care Organization,

21 Related Conditions unless there is clear evidence that a condition is unrelated to the terminal prognosis; all services would be considered related. It is also the responsibility of the hospice physician to document why a patient s medical needs would be unrelated to the terminal prognosis. all of a patient s coexisting or additional diagnoses related to the terminal illness or related conditions should be reported on the hospice claim. 78 Federal Register 152 (7 August 2013), pp , National Hospice and Palliative Care Organization,

22 Related Conditions this determination of what is related versus unrelated to the terminal prognosis remains within the clinical expertise and judgment of the hospice medical director in collaboration with the IDG. necessary for these decisions to be made on a case-by-case basis 78 Federal Register 152 (7 August 2013), p National Hospice and Palliative Care Organization,

23 Definitions Term Primary diagnosis Secondary diagnosis Unrelated diagnosis Definition The principal diagnosis determined as the diagnosis most contributory to the terminal prognosis. Related to either the terminal prognosis or the primary diagnosis Condition UNrelated to the terminal prognosis OR the primary diagnosis OR a secondary diagnosis National Hospice and Palliative Care Organization,

24 Determining Relatedness National Hospice and Palliative Care Organization,

25 Why all the Fuss? CMS discussion about relatedness Virtually all care at EOL is related Diagnoses on claim form FY 2014 Hospice Wage Index Rule FY 2015 Hospice Wage Index Rule Abt data related to $ leakage in to Medicare Parts A, B, D Proposed definitions for terminally ill and related conditions Virtually all care at EOL is related Diagnoses on claim form $ leakage in to Medicare Parts A, B, D Virtually all care at EOL is related Co-morbidities Diagnoses on claim form FY 2016 Hospice Wage Index Rule National Hospice and Palliative Care Organization,

26 NHPCO Relatedness Workgroup A subcommittee of the NHPCO Regulatory Committee. Formed in 2013 in response to FY 2014 proposed Hospice Wage Index Rule. The group s mission was to develop resources for the NHPCO membership that will assist in determining related diagnoses, treatments, medications, supplies, and equipment for a patient. National Hospice and Palliative Care Organization,

27 Determining Relatedness Hospice physician reviews all available information Hospice physician confers with attending physician and IDT Determination made Relatedness is not determined by the CFO based on cost to hospice provider. It is determined patient by patient, case by case related to the palliative plan of care. National Hospice and Palliative Care Organization,

28 Role of the Nurse Provision of clinical information to the hospice physician. Comprehensive assessment History and physical Discharge summary from hospital Clinical information from attending physician National Hospice and Palliative Care Organization,

29 Role of the Other IDT Members Social worker, dietician, chaplain, Continuous provision of information to the hospice physician. Updated to the comprehensive assessment National Hospice and Palliative Care Organization,

30 Role of the Hospice Physician Determining the diagnoses is within the scope of practice of medicine Formal diagnoses for the record vs. nursing diagnoses Hospice physician can determine new diagnoses that are present but have not been previously designated formally Example: Dementia is documented in the record, but does not state the etiology of the dementia National Hospice and Palliative Care Organization, NHPCO, 2014

31 The Determination Process Is the condition being considered a diagnosis or a symptom (or both)? Diagnoses will need a determination of whether they are related or unrelated Symptoms are almost automatically related (Coding guidelines state these do not need to be listed if they are a normal part of the diagnosis) What if they are both diagnosis and symptom? (Example: Depression) National Hospice and Palliative Care Organization,

32 The Determination Process Is there active pain or an active symptom? Should be considered related Is there a likelihood of pain or another symptom? Should be considered related Questions about: Arthritis pain, Migraine prophylaxis, etc. National Hospice and Palliative Care Organization,

33 The Determination Process Is the diagnosis caused by or causing the terminal condition? Some obvious examples include: HIV AIDS Ischemic heart disease Congestive heart failure Cerebral atherosclerosis Vascular dementia How far do you drill down? Diabetes mellitus Diabetic nephropathy ESRD HTN Hypertensive nephropathy ESRD DMT2 National Hospice and Palliative Care Organization,

34 The Determination Process Is the diagnosis in question stable? If not requiring management Does not need to listed Example: Remote prostate cancer If requiring management, does the treatment interact or potentially interact with the terminal illness? Determined case by case National Hospice and Palliative Care Organization,

35 Other Considerations All determinations must be done with consideration of the patient s prognosis If not eligible all the above is moot (Discharge (or do not admit) the patient) If any DX (or TX for a DX) contributes to the terminal prognosis it is related Is a TX under consideration still beneficial within the patient s expected prognosis? May still be related, but should be discontinued National Hospice and Palliative Care Organization,

36 Common Denominator All the above determinations require medical judgment The hospice physician must complete the documentation Must have hospice physicians who can make such decisions Must have adequate information on the patient s status National Hospice and Palliative Care Organization,

37 Relatedness Flow Chart Determining relatedness is a continuous process by the hospice physician which takes into account the changes in the patient's condition. National Hospice and Palliative Care Organization,

38 National Hospice and Palliative Care Organization,

39 Case Study #1 Mona is 84 and has a 5 year history of dementia. She is now nonverbal and has lost the ability to walk. She now weighs 99 Lbs, down from 105 lbs 4 months ago. She was recently hospitalized for pneumonia and had developed diarrhea, C diff positive. She will be coming home on medications for C diff. Is the C diff related to the patient s prognosis? Yes. The pneumonia is related to the dementia and is contributing to the terminal prognosis. The treatment of the pneumonia resulted in C Diff. National Hospice and Palliative Care Organization,

40 Case Study #2 Arthur is 77 and is diagnosed with advanced Alzheimer s disease, debility, AFFT, and hyperlipidemia. He is a resident of a long term care facility and was recently referred to hospice after a 13% weight loss in 6 months. Which diagnosis is not related to the terminal prognosis? The patient s hyperlipidemia is irrelevant to his terminal Alzheimer s disease, in the face of no oral intake, and it therefore has no bearing on his prognosis. National Hospice and Palliative Care Organization,

41 NHPCO Resources co.org/regulator y-compliancehospices/determ ining-terminalprognosis National Hospice and Palliative Care Organization,

42 Coverage per the Regulations Requirements for coverage. To be covered, hospice services must be reasonable and necessary for the palliation or management of the terminal illness as well as related conditions Covered services. (f) Medical appliances and supplies, including drugs and biologicals. Only drugs which are used primarily for the relief of pain and symptom control related to the individual's terminal illness are covered. National Hospice and Palliative Care Organization,

43 Buckets of Relatedness RELATED and HELPFUL RELATED BUT NOT HELPFUL RELATED BUT NOT ON FORMULARY UNRELATED & HELPFUL PART D ELIGIBLE UNRELATED, BUT NO LONGER HELPFUL National Hospice and Palliative Care Organization,

44 Related vs. Unrelated, unless there is clear evidence that a condition is unrelated to the terminal prognosis; all services would be considered related. It is also the responsibility of the hospice physician to document why a patient s medical needs would be unrelated to the terminal prognosis. 78 Federal Register 152 (7 August 2013), p National Hospice and Palliative Care Organization,

45 Documenting Un-relatedness It is the hospice physician s responsibility to document what is unrelated Where should that occur? In the certification narrative? Not the best place In a progress note? May be hard to locate In the med profile? Include non-med treatments? Stand-alone document? EMR vs. Paper documentation concerns National Hospice and Palliative Care Organization,

46 Documenting Unrelatedness cont What does the hospice physician document? CMS has providing varying guidance on this Recent CMS Open Door Forum call: should be a brief narrative that is reasonable in explaining why the condition is unrelated National Hospice and Palliative Care Organization,

47 Examples of Unrelatedness Two examples are repeatedly offered for unrelatedness Neither has been validated by CMS 1. Glaucoma is pathophysiologically unrelated to the patient s lung cancer, and does not contribute to the terminal prognosis. 2. Hypothyroidism is physiologically unrelated to the patient s COPD, and since it is well managed, it does not contribute to a worsened prognosis. National Hospice and Palliative Care Organization,

48 Reasonable and Necessary The Medicare Hospice Benefit requires the hospice to cover all reasonable and necessary palliative care related to the terminal prognosis and related conditions. Section 1862(a)(1)(C) of the Social Security Act (the Act) forbids payment for any items or services which are not reasonable and necessary for the palliation and management of the terminal illness. Services which are not needed... would not be reasonable and necessary. 78 Federal Register 152 (7 August 2013), p.48236, National Hospice and Palliative Care Organization,

49 All Diagnoses on the Claim Form For service dates of October 1, 2015 and forward, all diagnoses (related & unrelated) must be entered on the hospice claim form An unrelated diagnosis on the claims form does not necessarily equal hospice responsibility If a hospice physician determines that a diagnosis does not medically contribute to the terminal prognosis, he/she documents why it does not medically contribute to the terminal prognosis in the clinical record National Hospice and Palliative Care Organization,

50 Medications National Hospice and Palliative Care Organization,

51 51 If medication is deemed related Hospice covers the cost Care (services, treatment, etc. ) Medications DME & supplies Documentation should appear in the clinical record that it is related Physician narrative Plan of care Medication profile 51 National Hospice and Palliative Care Organization, 2015

52 Related and NOT in Plan of Care Not effective not supported by the evidence or truly necessary May be harmful for reasons not usually thought of by patients and families not free from harm Duplicate medications Not on hospice formulary or preferred med list And pt/family decline an equivalent medication that would be covered National Hospice and Palliative Care Organization,

53 If medication is deemed unrelated CMS expects that another health care professional would come to the same conclusion after reviewing the same data Subject to MAC and auditor review Subject to Part D plan sponsor review Audits directed to start again with 2014 Part D claims Documentation should appear in the clinical record that it is NOT related Consistent, accessible location We expect drugs covered under Part D for hospice beneficiaries will be extremely rare. National Hospice and Palliative 53 Care Organization, 2015

54 Payment Responsibility Medications that WERE for the treatment of the terminal illness and/or related conditions prior to hospice admission will be discontinued as determined by the hospice IDG and discussed with patient/family because medications are no longer effective and/or causing additional negative symptoms. NOT covered under the MHB (not reasonable or necessary for the palliation of pain and/or symptom management). If beneficiary still chooses to have these medications, costs would be a beneficiary liability (not MHB or Part D) National Hospice and Palliative Care Organization,

55 Payment Responsibility If a beneficiary requests a drug for his/her terminal illness or related conditions that is NOT on the hospice formulary and the beneficiary refuses to try a formulary equivalent first or is determined by the hospice to be unreasonable or unnecessary for the palliation of pain and/or symptom management the beneficiary may opt to assume financial responsibility for the drug No payment for the drug will be available under Part D. National Hospice and Palliative Care Organization,

56 Dementia Medication Dementia medications (Aricept, Namenda, Exelon, Razadyne ) are less helpful and more harmful in advanced disease. Side effects: weight loss, bad dreams, sleep disturbances, bradycardia, and increased restlessness. NOT indicated or covered with FAST 7 without clear and ongoing benefit in managing identifiable and distressing behaviors. May be covered with FAST 6; discuss goals/outcomes with hospice physician or pharmacist. Two week tapering supply COVERED if med discontinued and an additional supply is needed. National Hospice and Palliative Care Organization,

57 Medical directors: Decisions Diagnoses Related or unrelated to the terminal prognosis Case-by-case Consistent reasoning that staff can understand and communicate Medications Related, reasonable, and necessary Clinically useful Covered by hospice or insurance National Hospice and Palliative Care Organization,

58 Medical Directors: Diagnoses The principal diagnosis should be the condition determined by the certifying hospice physician(s) as the diagnosis most contributory to the terminal decline. Certifying physicians should use their best clinical judgment in determining the principal diagnosis and related conditions, based on the hospice comprehensive assessment and review of any and all other clinical documentation. 78 Federal Register 152 (7 August 2013), p.48240, National Hospice and Palliative Care Organization,

59 Medical Directors: Documentation It is the responsibility of the hospice physician to document why a patient s medical needs would be unrelated to the terminal prognosis. Hypothyroidism and early dementia dx/meds not related to prognosis or to the POC for palliation/management of metastatic lung cancer. National Hospice and Palliative Care Organization,

60 Medical Directors: Documentation Must have a place and a process to determine and document Relatedness of diagnoses Medication: related, reasonable, necessary, covered Timely and accessible to the IDG Useful Wording must designate reasons for coverage decisions Defensibility National Hospice and Palliative Care Organization,

61 Make Good Choices Patient/family/community trust Do no harm! Financial consequences to the patient Financial consequences to the hospice Potential legal and/or compliance consequences Incur the wrath of Medicare National Hospice and Palliative Care Organization,

62 Hospice Risk Area Failure to identify and claim responsibility for a diagnosis and condition that contributes to the terminal prognosis. Increases risk for audit and financial penalty. Increases risk for Medicare decertification. National Hospice and Palliative Care Organization,

63 National Hospice and Palliative Care Organization,

64 References Subpart B Eligibility, Election and Duration of Benefits vol3/pdf/cfr-2011-title42-vol3-part418-subpartb.pdf Medicare Benefit Policy Manual Chapter 9 - Coverage of Hospice Services Under Hospital Insurance Guidance/Guidance/Manuals/Downloads/bp102c09.pdf Link to NHPCO Regulatory Alerts for Wage Index Rules ( ) National Hospice and Palliative Care Organization,

Medication Coordination and Coverage in Hospice

Medication Coordination and Coverage in Hospice Medication Coordination and Coverage in Hospice Alen Voskanian, MD, FAAHPM, AAHIVS Regional Medical Director, VITAS Innovative Hospice Care Assistant Clinical Professor of Medicine, David Geffen School

More information

Hospice Certification, Care Planning and Documentation:

Hospice Certification, Care Planning and Documentation: Hospice Certification, Care Planning and Documentation: Created by: Created by: Brenda Lovelady, Liberty Hospital Hospice Presented by: Robin Carnett, Heartland Hospice Hospice Certification Written certification

More information

FY2015 Hospice Wage Index Proposed Rule

FY2015 Hospice Wage Index Proposed Rule FY2015 Hospice Wage Index Proposed Rule To: NHPCO Members From: NHPCO Health Policy Team Date: May 6, 2014 Summary of FY2015 Hospice Wage Index Proposed Rule On Friday, May 2 2014, CMS released the FY2015

More information

Palliative Medicine and The Nurse Practitioner

Palliative Medicine and The Nurse Practitioner Palliative Medicine and The Nurse Practitioner ANNE MOORE, FNP-C CONTACT INFO: JEWISH HOME CENTER FOR PALLIATIVE MEDICINE A PROGRAM OF SKIRBALL HOSPICE AND THE LOS ANGELES JEWISH HOME 6345 BALBOA BLVD.

More information

CLINICAL DOCUMENTATION SYSTEM FOR HOSPICE

CLINICAL DOCUMENTATION SYSTEM FOR HOSPICE CLINICAL DOCUMENTATION SYSTEM FOR HOSPICE Table of Contents HOSPICE CLINICAL DOCUMENTION SYSTEM FOR HOSPICE INSTRUCTION MANUAL Document Title Form# Page # Attending Physician Initial Certification of Terminal

More information

Coding. Future of Hospice. and the. An educational resource presented by

Coding. Future of Hospice. and the. An educational resource presented by An educational resource presented by Coding and the Future of Hospice You know incorrect coding hurts your reimbursement. Did you know it also shapes CMS rules? Prepared by In this white paper, we will:

More information

Navigating CMS Guidance on Part D Callene Bentoncoury, RN, BSN, MA Administrator, Casa de la Luz Hospice Julia Choate, RN, BSN Director of Quality &

Navigating CMS Guidance on Part D Callene Bentoncoury, RN, BSN, MA Administrator, Casa de la Luz Hospice Julia Choate, RN, BSN Director of Quality & Navigating CMS Guidance on Part D Callene Bentoncoury, RN, BSN, MA Administrator, Casa de la Luz Hospice Julia Choate, RN, BSN Director of Quality & Compliance, Casa de la Luz Hospice Greg Dyke, Rph President

More information

Ann Hablitzel, RN, BSN, MBA Hospice Care of California

Ann Hablitzel, RN, BSN, MBA Hospice Care of California Ann Hablitzel, RN, BSN, MBA Hospice Care of California Objectives Describe the creations of new community based palliative care programs Identify criteria for admission Discuss philosophy and goals Analyze

More information

MEDICARE RISK ADJUSTMENT A PROSPECTIVE APPROACH TO RISK ADJUSTMENT AND ACCURATE DOCUMENTATION AND CODING

MEDICARE RISK ADJUSTMENT A PROSPECTIVE APPROACH TO RISK ADJUSTMENT AND ACCURATE DOCUMENTATION AND CODING MEDICARE RISK ADJUSTMENT A PROSPECTIVE APPROACH TO RISK ADJUSTMENT AND ACCURATE DOCUMENTATION AND CODING WHAT IS RISK ADJUSTMENT? Risk Adjustment ensures that accurate payments are made to Medicare Advantage

More information

Hospice Update. Annette T. Carron, D.O., CMD, FAAHPM, FACOI Director Geriatrics and Palliative Care Botsford Hospital Farmington Hills, MI

Hospice Update. Annette T. Carron, D.O., CMD, FAAHPM, FACOI Director Geriatrics and Palliative Care Botsford Hospital Farmington Hills, MI Hospice Update Annette T. Carron, D.O., CMD, FAAHPM, FACOI Director Geriatrics and Palliative Care Botsford Hospital Farmington Hills, MI Sudden death, unexpected cause < 10%, MI, accident, etc Health

More information

Hospice care services

Hospice care services Hospice care services Summary of change: Effective February 1, 2015, hospice services will be a covered benefit covered by Amerigroup Louisiana, Inc. Amerigroup Louisiana, Inc. recognizes the importance

More information

EndLink: An Internet-based End of Life Care Education Program www.endlink.rhlurie.northwestern.edu ABOUT HOSPICE CARE

EndLink: An Internet-based End of Life Care Education Program www.endlink.rhlurie.northwestern.edu ABOUT HOSPICE CARE EndLink: An Internet-based End of Life Care Education Program www.endlink.rhlurie.northwestern.edu ABOUT HOSPICE CARE What is hospice? Hospice care focuses on improving the quality of life for persons

More information

Hospice and Palliative Care: Help Throughout Life s Journey. John P. Langlois MD CarePartners Hospice and Palliative Care

Hospice and Palliative Care: Help Throughout Life s Journey. John P. Langlois MD CarePartners Hospice and Palliative Care Hospice and Palliative Care: Help Throughout Life s Journey John P. Langlois MD CarePartners Hospice and Palliative Care Goals Define Palliative Care and Hospice. Describe and clarify the differences and

More information

Frequently Asked Questions Regarding At Home and Inpatient Hospice Care

Frequently Asked Questions Regarding At Home and Inpatient Hospice Care Frequently Asked Questions Regarding At Home and Inpatient Hospice Care Contents Page: Topic Overview Assistance in Consideration Process Locations in Which VNA Provides Hospice Care Determination of Type

More information

Hospice Care. To Make a No Obligation No Cost Referral Contact our Admissions office at: Phone: 541-512-5049 Fax: 888-611-8233

Hospice Care. To Make a No Obligation No Cost Referral Contact our Admissions office at: Phone: 541-512-5049 Fax: 888-611-8233 To Make a No Obligation No Cost Referral Contact our Admissions office at: Compliments of: Phone: 541-512-5049 Fax: 888-611-8233 Office Locations 29984 Ellensburg Ave. Gold Beach, OR 97444 541-247-7084

More information

Guideline for Estimating Length of Survival in Palliative Patients

Guideline for Estimating Length of Survival in Palliative Patients Guideline for Estimating Length of Survival in Palliative Patients Cornelius Woelk MD, CCFP Medical Director of Palliative Care Regional Health Authority - Central Manitoba 385 Main Street Winkler, Manitoba,

More information

Hospice Widespread edits

Hospice Widespread edits Hospice Widespread edits Befriend this foe to prevent claim denials Beth Noyce, RN, BSJMC, HCS-D D, COS-C C Clinical Educator & QA Specialist and Dana Walling, RN, COS-C Director of Nursing, Branch Manager

More information

Subject: Request for Comments: Part D Payment for Drugs for Beneficiaries Enrolled in Hospice

Subject: Request for Comments: Part D Payment for Drugs for Beneficiaries Enrolled in Hospice January 10, 2014 Cynthia G. Tudor, Ph.D., Director Medicare Drug Benefit and C & D Data Group Laurence Wilson, Director Chronic Care Policy Group Mark Majestic, Director Medicare Program Integrity Group

More information

Hospice Care It s About How You Live

Hospice Care It s About How You Live Hospice Care It s About How You Live Beth Mahar, Director of Member Services Hospice & Palliative Care Association of NYS Thank you to: Elizabeth Peters RN The Community Hospice of Columbia/Greene Mission

More information

Hospice Care in The Nursing Home. Perspectives of a Medical Director Carole Baraldi, M.D.

Hospice Care in The Nursing Home. Perspectives of a Medical Director Carole Baraldi, M.D. Hospice Care in The Nursing Home Perspectives of a Medical Director Carole Baraldi, M.D. Evolution of Nursing Facilities Alms houses began over 1000 years ago Historically serve older people who can no

More information

Introduction to Hospice

Introduction to Hospice Introduction to Hospice Objectives The learner will be able to: Understand general hospice services Discuss ways that hospice services can be accessed Discuss Medicare regulations for hospice services

More information

Hospice Case Management

Hospice Case Management Defining Quality Hospice Case Management Cindy Henderson, BSN, RN, CHPN Director of Operations Acclaim Hospice and Palliative Care Kindred Healthcare, Inc. Objectives At the end of the session, participants

More information

Hospice and Palliative Care What s the right choice for my patient? Learning objectives. My palliative care education 9/18/2015

Hospice and Palliative Care What s the right choice for my patient? Learning objectives. My palliative care education 9/18/2015 Hospice and Palliative Care What s the right choice for my patient? Sharon Benjamin, ANP, MSN, ACHPN Providence Hospice Learning objectives Participants will be able to Describe the relationship between

More information

HOSPICE INFORMED CONSENT

HOSPICE INFORMED CONSENT HOSPICE INFORMED CONSENT PATIENT NAME: INSTRUCTIONS: This form is used to acknowledge receipt of our Orientation Booklet and confirm your understanding and agreement with its contents. Your signature below

More information

High Desert Medical Group Connections for Life Program Description

High Desert Medical Group Connections for Life Program Description High Desert Medical Group Connections for Life Program Description POLICY: High Desert Medical Group ("HDMG") promotes patient health and wellbeing by actively coordinating services for members with multiple

More information

A Comprehensive Case Management Program to Improve Access to Palliative Care. Aetna s Compassionate Care SM

A Comprehensive Case Management Program to Improve Access to Palliative Care. Aetna s Compassionate Care SM A Comprehensive Case Management Program to Improve Access to Palliative Care Aetna s Compassionate Care SM Our chief want in life is somebody who shall make us do what we can. Ralph Waldo Emerson Marcia

More information

See page 331 of HEDIS 2013 Tech Specs Vol 2. HEDIS specs apply to plans. RARE applies to hospitals. Plan All-Cause Readmissions (PCR) *++

See page 331 of HEDIS 2013 Tech Specs Vol 2. HEDIS specs apply to plans. RARE applies to hospitals. Plan All-Cause Readmissions (PCR) *++ Hospitalizations Inpatient Utilization General Hospital/Acute Care (IPU) * This measure summarizes utilization of acute inpatient care and services in the following categories: Total inpatient. Medicine.

More information

Medicare Risk-Adjustment & Correct Coding 101. Rev. 10_31_14. Provider Training

Medicare Risk-Adjustment & Correct Coding 101. Rev. 10_31_14. Provider Training Medicare Risk-Adjustment & Correct Coding 101 Rev. 10_31_14 Provider Training Objectives Medicare Advantage - Overview Risk Adjustment 101 Coding and Medical Record Documentation Requirements Medicare

More information

James F. Kravec, M.D., F.A.C.P

James F. Kravec, M.D., F.A.C.P James F. Kravec, M.D., F.A.C.P Chairman, Department of Internal Medicine, St. Elizabeth Health Center Chair, General Internal Medicine, Northeast Ohio Medical University Associate Medical Director, Hospice

More information

Special Needs Plan Model of Care 101

Special Needs Plan Model of Care 101 Special Needs Plan Model of Care 101 What is a Special Needs Plan? First of all it s a Medicare MA-PD, typically an HMO Consists of Medicare enrollees who meet special eligibility requirements In our case

More information

Frequently Asked Questions about Pediatric Hospice and Pediatric Palliative Care

Frequently Asked Questions about Pediatric Hospice and Pediatric Palliative Care Frequently Asked Questions about Pediatric Hospice and Pediatric Palliative Care Developed by the New Jersey Hospice and Palliative Care Organization Pediatric Council Items marked with an (H) discuss

More information

Engaging Spirituality in Social Work for Palliative Care and Hospice

Engaging Spirituality in Social Work for Palliative Care and Hospice Engaging Spirituality in Social Work for Palliative Care and Hospice Conversations about Comfort, Support, and Quality of Life written by Palliative Care Consulting Team and Hwi-Ja Canda Lawrence Memorial

More information

HOSPICE AND PALLIATIVE CARE

HOSPICE AND PALLIATIVE CARE HOSPICE AND PALLIATIVE CARE What, Why, When, and How Debra Luczkiewicz MD Attending Physician Hospice Inpatient Unit Center for Hospice and Palliative Care, Buffalo, NY OBJECTIVES Define hospice and palliative

More information

Dementia in Hospice Care Part I: Stages, Hospice Guidelines, and Assessing Pain/Discomfort

Dementia in Hospice Care Part I: Stages, Hospice Guidelines, and Assessing Pain/Discomfort Dementia in Hospice Care Part I: Stages, Hospice Guidelines, and Assessing Pain/Discomfort Amy Corcoran, MD Clinical Instructor Division of Geriatrics, Department of Medicine December 5, 2007 Background

More information

Life Choices. What is Palliative Care? Palliative? Palliative care emerged. A Program of Palliative Care

Life Choices. What is Palliative Care? Palliative? Palliative care emerged. A Program of Palliative Care Life Choices A Program of Palliative Care Relieves suffering and improves quality of life for patients with advanced illnesses What is Palliative Care? Medical treatment that aims to relieve suffering

More information

b. Distinguish between different venues of senior residence c. Advocate the necessity of geriatrics as a true specialty

b. Distinguish between different venues of senior residence c. Advocate the necessity of geriatrics as a true specialty 1. Introduction/ Getting to know our Seniors a. Identify common concepts and key terms used when discussing geriatrics b. Distinguish between different venues of senior residence c. Advocate the necessity

More information

42 CFR 483.25 (F309) QUALITY OF CARE. Changes to Interpretive Guidance. Training Objectives. *Overview of changes

42 CFR 483.25 (F309) QUALITY OF CARE. Changes to Interpretive Guidance. Training Objectives. *Overview of changes 42 CFR 483.25 (F309) QUALITY OF CARE Changes to Interpretive Guidance 1 Training Objectives Review guidance for hospice and/or ESRD services, formerly in the SOM in Appendix P; Describe when to use F309

More information

Karen R. Waters. Advanced Nurse Practitioner and Professor Martin Johnson, University of Salford

Karen R. Waters. Advanced Nurse Practitioner and Professor Martin Johnson, University of Salford Dying with dementia: A retrospective case note analysis of nursing and care home residents who died in hospital. Karen R. Waters. Advanced Nurse Practitioner and Professor Martin Johnson, University of

More information

Medicare Risk Adjustment and You. Health Plan of San Mateo Spring 2009

Medicare Risk Adjustment and You. Health Plan of San Mateo Spring 2009 Medicare Risk Adjustment and You Health Plan of San Mateo Spring 2009 Background CMS reimburses health plans on a risk-adjusted basis: The sicker a member is expected to be, the more CMS pays a plan, which

More information

Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis

Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis Methodology: 8 respondents The measures are incorporated into one of four sections: Highly

More information

Ch. 1130 HOSPICE SERVICES 55 CHAPTER 1130. HOSPICE SERVICES GENERAL PROVISIONS RECIPIENT ELIGIBILITY AND DURATION OF COVERAGE

Ch. 1130 HOSPICE SERVICES 55 CHAPTER 1130. HOSPICE SERVICES GENERAL PROVISIONS RECIPIENT ELIGIBILITY AND DURATION OF COVERAGE Ch. 1130 HOSPICE SERVICES 55 CHAPTER 1130. HOSPICE SERVICES Sec. 1130.1. Statutory basis. 1130.2. Policy. 1130.3. Definitions. GENERAL PROVISIONS RECIPIENT ELIGIBILITY AND DURATION OF COVERAGE 1130.21.

More information

Hospice and Palliative Medicine

Hospice and Palliative Medicine Hospice and Palliative Medicine Maintenance of Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills

More information

IMPORTANT! READ CAREFULLY TO ENSURE THAT YOUR CLAIMS MEET THE NEW DIAGNOSIS CODING REQUIREMENTS

IMPORTANT! READ CAREFULLY TO ENSURE THAT YOUR CLAIMS MEET THE NEW DIAGNOSIS CODING REQUIREMENTS Invalid Hospice Diagnosis Codes, Effective October 1, 2014 To: NHPCO Members From: NHPCO Regulatory Team Date: October 2, 2014 IMPORTANT! READ CAREFULLY TO ENSURE THAT YOUR CLAIMS MEET THE NEW DIAGNOSIS

More information

Attachment A Minnesota DHS Community Service/Community Services Development

Attachment A Minnesota DHS Community Service/Community Services Development Attachment A Minnesota DHS Community Service/Community Services Development Applicant Organization: First Plan of Minnesota Project Title: Implementing a Functional Daily Living Skills Assessment to Predict

More information

Special Needs Plan Provider Education

Special Needs Plan Provider Education Special Needs Plan Provider Education Reviewed September 2014 Learning Goals What is a Special Needs Plan (SNPs) What differentiates a SNP from other MA plans What SNPs are offered by Freedom Health and

More information

What services are provided by JSSA Hospice? Our personalized services for patients and family members include:

What services are provided by JSSA Hospice? Our personalized services for patients and family members include: FAQ S ABOUT HOSPICE What is Hospice? Hospice is a specialized type of healthcare for patients and families who are faced with a terminal illness. A team of physicians, nurses, social workers, bereavement

More information

Finding Meaning and Purpose in Palliative Care

Finding Meaning and Purpose in Palliative Care Finding Meaning and Purpose in PALLIATIVE CARE WHAT IS IT? Jeffrey Rubins, MD Director, Palliative Medicine Hennepin Health Services deriv. from pallium, to cloak How do you pronounce palliative? medical

More information

Kaiser Permanente Guide to Medicare Basics

Kaiser Permanente Guide to Medicare Basics Kaiser Permanente Guide to Medicare Basics The National Medicare program, which was created in 1965, has given people peace of mind and the security of knowing they ll have access to health coverage. Medicare

More information

David Eubanks, RN, MSN Billie Papasifakis, RN-BC, MSN, AACC. Describe model of care most appropriate

David Eubanks, RN, MSN Billie Papasifakis, RN-BC, MSN, AACC. Describe model of care most appropriate THE BRIDGE PROGRAM David Eubanks, RN, MSN Billie Papasifakis, RN-BC, MSN, AACC Pamela Teenier, RN, MBA, COC-C, C HCS-D HCSD 1 Objectives Describe model of care most appropriate for a Bridge program from

More information

Rehabilitation s Role in Decreasing Returns to Acute Care

Rehabilitation s Role in Decreasing Returns to Acute Care Rehabilitation s Role in Decreasing Returns to Acute Care Glenda Mack, PT, MSPT, MBA, CLT, CWS Division Vice President Clinical Operations, RehabCare Objectives Participants will verbalize three primary

More information

Holy Cross Palliative Care Program. Barb Supanich,RSM,MD Medical Director June 19,2007

Holy Cross Palliative Care Program. Barb Supanich,RSM,MD Medical Director June 19,2007 Holy Cross Palliative Care Program Barb Supanich,RSM,MD Medical Director June 19,2007 Goals Define Palliative Care Scope of Palliative Care Palliative Care Services at Holy Cross Hospital Definition of

More information

Department of Veterans Affairs VHA HANDBOOK 1140.5. Washington, DC 20420 March 1, 2005 COMMUNITY HOSPICE CARE: REFERRAL AND PURCHASE PROCEDURES

Department of Veterans Affairs VHA HANDBOOK 1140.5. Washington, DC 20420 March 1, 2005 COMMUNITY HOSPICE CARE: REFERRAL AND PURCHASE PROCEDURES Department of Veterans Affairs VHA HANDBOOK 1140.5 Veterans Health Administration Transmittal Sheet Washington, DC 20420 March 1, 2005 COMMUNITY HOSPICE CARE: REFERRAL AND PURCHASE PROCEDURES 1. REASON

More information

HOSPICE CARE. and the Medicare Hospice Benefit

HOSPICE CARE. and the Medicare Hospice Benefit For more information, or to locate a hospice in your area, contact Caring Connections: www.caringinfo.org caringinfo@nhpco.org HelpLine 800.658.8898 Multilingual Line 877.658.8896 Item #: 810002 Hospice

More information

Chart 11-1. Number of dialysis facilities is growing, and share of for-profit and freestanding dialysis providers is increasing

Chart 11-1. Number of dialysis facilities is growing, and share of for-profit and freestanding dialysis providers is increasing 11 0 Chart 11-1. Number of dialysis facilities is growing, and share of for-profit and freestanding dialysis providers is increasing Average annual percent change 2014 2009 2014 2013 2014 Total number

More information

Submitted Electronically RE: CMS-1609-P: ISSUE # 1: Solicitation of Comments on Definitions of Terminal Illness and Related Conditions :

Submitted Electronically RE: CMS-1609-P: ISSUE # 1: Solicitation of Comments on Definitions of Terminal Illness and Related Conditions : June 20, 2014 Submitted Electronically Ms. Marilyn B. Tavenner Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services 200 Independence Avenue, SW Washington, DC

More information

Impact of Wage Index Changes (6 th year of BNAF phase out and wage index changes): minus 0.7 percentage points

Impact of Wage Index Changes (6 th year of BNAF phase out and wage index changes): minus 0.7 percentage points TOPIC PROPOSED RULE SUMMARY COMMENT Rates and Estimated hospital market basket update: 2.7 percent Aggregate Cap PROPOSAL Impact of ACA Reductions: minus 0.7 percentage points Impact of Wage Index Changes

More information

Physical and Mental Health Condition Prevalence and Comorbidity among Fee-for-Service Medicare- Medicaid Enrollees

Physical and Mental Health Condition Prevalence and Comorbidity among Fee-for-Service Medicare- Medicaid Enrollees Physical and Mental Health Condition Prevalence and Comorbidity among Fee-for-Service Medicare- Medicaid Enrollees Centers for Medicare & Medicaid Services September, 2014 i Executive Summary Introduction

More information

Quality Measures for Long-stay Residents Percent of residents whose need for help with daily activities has increased.

Quality Measures for Long-stay Residents Percent of residents whose need for help with daily activities has increased. Quality Measures for Long-stay Residents Percent of residents whose need for help with daily activities has increased. This graph shows the percent of residents whose need for help doing basic daily tasks

More information

Henry Ford Health System Care Coordination and Readmissions Update

Henry Ford Health System Care Coordination and Readmissions Update Henry Ford Health System Care Coordination and Readmissions Update September 2013 BACKGROUND Most hospital readmissions are viewed as avoidable, costly, and in some cases as a potential marker of poor

More information

Tae J Lee, MD, CMD, AGSF Medical Director Palliative Care and Hospice Vidant Medical Center

Tae J Lee, MD, CMD, AGSF Medical Director Palliative Care and Hospice Vidant Medical Center Tae J Lee, MD, CMD, AGSF Medical Director Palliative Care and Hospice Vidant Medical Center Objectives Discuss important healthcare issues for aging population Review long term care options Discuss advance

More information

Establishing an Advanced Illness Management (AIM) Model in a Community-Based Setting

Establishing an Advanced Illness Management (AIM) Model in a Community-Based Setting Establishing an Advanced Illness Management (AIM) Model in a Community-Based Setting Health Care Workforce for Older Americans: Promoting Team Care October 7, 2008 Panel on Models of Team Care for the

More information

Your Guide to Medicare Special Needs Plans (SNPs)

Your Guide to Medicare Special Needs Plans (SNPs) CENTERS FOR MEDICARE & MEDICAID SERVICES Your Guide to Medicare Special Needs Plans (SNPs) This official government booklet has important information about Medicare Special Needs Plans, including the following:

More information

Hospice Manual for Facility

Hospice Manual for Facility Hospice Manual for Facility Home Health & Hospice Hospice in the Facility Objectives 1. Identify the mechanism for providing government regulated care in the facility. 2. Identify the Hospice policy and

More information

Don t Delay Hospice Care Referrals

Don t Delay Hospice Care Referrals Don t Delay Hospice Care Referrals Timely hospice admissions provide greater benefits. Among the Medicare population, about nine out of 10 deaths are associated with chronic illnesses, such as cancer,

More information

Compliance Tip Sheet CMS FY 2010 TOP TEN HOSPICE SURVEY DEFICIENCIES COMPLIANCE RECOMMENDATIONS CMS TOP TEN HOSPICE SURVEY DEFICIENCIES

Compliance Tip Sheet CMS FY 2010 TOP TEN HOSPICE SURVEY DEFICIENCIES COMPLIANCE RECOMMENDATIONS CMS TOP TEN HOSPICE SURVEY DEFICIENCIES Compliance Tip Sheet National Hospice and Palliative Care Organization www.nhpco.org/regulatory CMS FY 2010 TOP TEN HOSPICE SURVEY DEFICIENCIES COMPLIANCE RECOMMENDATIONS INTRODUCTION The Centers for Medicare

More information

Family Caregiver s Guide to Hospice and Palliative Care

Family Caregiver s Guide to Hospice and Palliative Care Family Caregiver Guide Family Caregiver s Guide to Hospice and Palliative Care Even though you have been through transitions before, this one may be harder. If you have been a family caregiver for a while,

More information

Application for Medicare Supplement

Application for Medicare Supplement Application for Medicare Supplement This application is subject to the approval of Blue Cross and Blue Shield of Nebraska. P.O. Box 2417 Omaha, NE 68103-2417 1 Tell us about yourself. Name (First, Middle,

More information

Caring About Palliative Care An overview

Caring About Palliative Care An overview Caring About Palliative Care An overview Developed by the Palliative Care Consultation Team at VH and C. Talbot, Palliative Care Consultation Team at UH Presented by: Lee Ann Craig NP, Palliative Care

More information

MEMO. Questions and Answers Related to the New Hospice Conditions of Participation {Effective 12/2/08}

MEMO. Questions and Answers Related to the New Hospice Conditions of Participation {Effective 12/2/08} MEMO Questions and Answers Related to the New Hospice Conditions of Participation {Effective 12/2/08} PATIENT RIGHTS 1) Is there any problem with agencies incorporating their agency grievance procedures

More information

Circle of Life: Cancer Education and Wellness for American Indian and Alaska Native Communities. Group Discussion True False Not Sure

Circle of Life: Cancer Education and Wellness for American Indian and Alaska Native Communities. Group Discussion True False Not Sure Hospice Care Group Discussion True False Not Sure 1. There is no difference between palliative care and hospice care. Palliative care is different from hospice care. Both palliative and hospice care share

More information

Medicare Supplement Application Aetna Life Insurance Company Aetna Administrator, P.O. Box 10374, Des Moines, IA 50306

Medicare Supplement Application Aetna Life Insurance Company Aetna Administrator, P.O. Box 10374, Des Moines, IA 50306 Medicare Supplement Application Aetna Administrator, P.O. Box 10374, Des Moines, IA 50306 INSTRUCTIONS: To be considered complete, all sections on this form must be filled out, unless marked optional.

More information

NAVIGATING THE MEDICARE MAZE OF REHABILITATIVE SERVICES

NAVIGATING THE MEDICARE MAZE OF REHABILITATIVE SERVICES NAVIGATING THE MEDICARE MAZE OF REHABILITATIVE SERVICES NAVIGATING THE COMPLEXITY OF INSURANCE COVERAGE. Fox Rehabilitation is a private practice of physical, occupational, and speech therapists who specialize

More information

Hospice Care. What is hospice care?

Hospice Care. What is hospice care? What is hospice care? Hospice Care You matter because of who you are. You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but also to live until

More information

GP SERVICES COMMITTEE Palliative Care INCENTIVES. Revised 2015. Society of General Practitioners

GP SERVICES COMMITTEE Palliative Care INCENTIVES. Revised 2015. Society of General Practitioners GP SERVICES COMMITTEE Palliative Care INCENTIVES Revised 2015 Society of General Practitioners GPSC Palliative Care Planning and Management Fees The following incentive payments are available to B.C. s

More information

ICD10-CM Codes. Hospice Top 20 and let s talk HIS. A Presentation of the Fazzi Coding Academy. December 2013. Presented by: Melanie Duerr, RN, MS, ANP

ICD10-CM Codes. Hospice Top 20 and let s talk HIS. A Presentation of the Fazzi Coding Academy. December 2013. Presented by: Melanie Duerr, RN, MS, ANP ICD10-CM Codes Hospice Top 20 and let s talk HIS A Presentation of the Fazzi Coding Academy December 2013 Presented by: Melanie Duerr, RN, MS, ANP Lisa Woolery, RN, BSN, BCHH-C Michelle Mantel, MSN, GNP-BC,

More information

2014 Hospice Regulatory Blueprint for Action

2014 Hospice Regulatory Blueprint for Action 2014 Hospice Regulatory Blueprint for Action Hospice Association of America 228 Seventh Street, SE Washington DC 20003-4306 1 Table of Contents INTRODUCTION... 3 WORK WITH STAKEHOLDERS TO CLARIFY RELATEDNESS

More information

Administrative Code. Title 23: Medicaid Part 205 Hospice Services

Administrative Code. Title 23: Medicaid Part 205 Hospice Services Title 23: Medicaid Administrative Code Title 23: Medicaid Part 205 Hospice Services Table of Contents Table of Contents Title 23: Division of Medicaid... 1 Part 205: Hospice Services... 1 Part 205 Chapter

More information

EPEC. Education for Physicians on End-of-life Care. Trainer s Guide

EPEC. Education for Physicians on End-of-life Care. Trainer s Guide EPEC Education for Physicians on End-of-life Care Trainer s Guide Procedure/Diagnosis Coding and Reimbursement Mechanisms for Physician Services in Palliative Care EPEC Project, The Robert Wood Johnson

More information

DEPARTMENT OF HEALTH AND HUMAN SERVICES. Medicare Program; Request for Applications for the Medicare Care Choices Model

DEPARTMENT OF HEALTH AND HUMAN SERVICES. Medicare Program; Request for Applications for the Medicare Care Choices Model DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-5512-N] Medicare Program; Request for Applications for the Medicare Care Choices Model AGENCY: Centers for Medicare

More information

Pain and symptom management. For persons. Alzheimer s Disease and Hospice Care. What is Hospice Care? Hospice Can Help. Hospice

Pain and symptom management. For persons. Alzheimer s Disease and Hospice Care. What is Hospice Care? Hospice Can Help. Hospice Caregivers Guidance Pain management Hospice Can Help Assistance Compassion Support Hospice What is Hospice Care? Alzheimer s Disease and Hospice Care Presented by Hospice Foundation of America, in Partnership

More information

Application for Life Insurance American Memorial Life Insurance Company P.O. Box 2730 Rapid City, SD 57709

Application for Life Insurance American Memorial Life Insurance Company P.O. Box 2730 Rapid City, SD 57709 Application for Life Insurance American Memorial Life Insurance Company P.O. Box 2730 Rapid City, SD 57709 HOME OFFICE USE ONLY # Any person who knowingly presents a false or fraudulent claim for payment

More information

2015 Orange County HICAP Medicare Advantage Special Needs Plans Comparison Chart

2015 Orange County HICAP Medicare Advantage Special Needs Plans Comparison Chart Brand New Day Brand New Day Brand New Day Brand New Day Bridges Drug Savings Bridges Extra Care Harmony Healthy Heart Drug Savings dementia. dementia. chronic and disabling mental health conditions. chronic

More information

SIP 222010 TO: Donald M. Berwick, M.D. Administrator Centers for Medicare & Medicaid Services

SIP 222010 TO: Donald M. Berwick, M.D. Administrator Centers for Medicare & Medicaid Services DEPARTMENT OF HEALTH &. HUMAN SERVICES Office of Inspector General Washington, D.C. 20201 SIP 222010 TO: Donald M. Berwick, M.D. Administrator Centers for Medicare & Medicaid Services FROM: Stuat1 Wright

More information

What is Palliative Care

What is Palliative Care What is Palliative Care Maine Quality Counts Portland Regional Forum Isabella N. Stumpf, DO Division Director, Palliative Medicine, Maine Medical Center Medical Director, Palliative Care, MaineHealth Disclosure

More information

Depression in Older Persons

Depression in Older Persons Depression in Older Persons How common is depression in later life? Depression affects more than 6.5 million of the 35 million Americans aged 65 or older. Most people in this stage of life with depression

More information

Interviewable: Yes No Resident Room: Initial Admission Date: Care Area(s): Use

Interviewable: Yes No Resident Room: Initial Admission Date: Care Area(s): Use Facility Name: Facility ID: Date: Surveyor Name: Resident Name: Resident ID: Initial Admission Date: Care Area(s): Interviewable: Yes No Resident Room: Use Use this protocol for a sampled resident receiving

More information

Update on New Coordination of Care and Transition of Care Coding

Update on New Coordination of Care and Transition of Care Coding Update on New Coordination of Care and Transition of Care Coding Michele Olivier ACP Colorado Chapter February 5, 2015 (303) 801-0123 Agenda Introduction Chronic Care Management Coding Advanced Care Planning

More information

Developed by the Oregon POLST Task Force. POLST is usually not for persons with stable long-term disabilities

Developed by the Oregon POLST Task Force. POLST is usually not for persons with stable long-term disabilities Physician Orders for Life-Sustaining Treatment (POLST) Use for Persons with Significant Physical Disabilities, Developmental Disabilities and/or Significant Mental Health Condition who are Now Near the

More information

The Value Quadrant of Healthcare Reform. 2008 Pharos Innovations, LLC. All Rights Reserved.

The Value Quadrant of Healthcare Reform. 2008 Pharos Innovations, LLC. All Rights Reserved. The Value Quadrant of Healthcare Reform ACOs in PPACA Provider Organizations or networked groups Accountable for quality, cost and overall care of defined population of Medicare FFS benes Key metrics to

More information

Partnering for Success. The Nursing Facility and Hospice Partnership to Provide End-of-Life Care To Nursing Facility Residents

Partnering for Success. The Nursing Facility and Hospice Partnership to Provide End-of-Life Care To Nursing Facility Residents Partnering for Success The Nursing Facility and Hospice Partnership to Provide End-of-Life Care To Nursing Facility Residents 1 What will I learn today? Attitudes towards death & dying Overview of hospice

More information

Reflections on End of Life Care in Hua Mei Mobile Clinic

Reflections on End of Life Care in Hua Mei Mobile Clinic Reflections on End of Life Care in Hua Mei Mobile Clinic Ng Wai Chong MBBS, GDGM Tsao Foundation Dec 2012 Scope Hua Mei Mobile Clinic its Function and Design Case Study Case Series of Patients in the EoL

More information

Care Coordination. The Embedded Care Manager. Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed

Care Coordination. The Embedded Care Manager. Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed Care Coordination The Embedded Care Manager Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed Goals of Care Management The goals of care Management are consistent with the Triple Aim: Improve population

More information

ICD-9-CM/ICD-10-CM Codes for MNT

ICD-9-CM/ICD-10-CM Codes for MNT / Codes for MNT ICD (International Classification of Diseases) codes are used by physicians and medical coders to assign medical diagnoses to individual patients. It is not within the scope of practice

More information

Can You Purchase Life Insurance If You

Can You Purchase Life Insurance If You Can You Purchase Life Insurance If You Are Diabetic Have Heart Disease Are Fighting MS Abused Drugs or Alcohol Have a History of Cancer Or Other Serious Illness InsuranceNebraska.org (800) 882-5009 The

More information

HOSPICE PROVIDER MANUAL Chapter twenty-four of the Medicaid Services Manual

HOSPICE PROVIDER MANUAL Chapter twenty-four of the Medicaid Services Manual HOSPICE PROVIDER MANUAL Chapter twenty-four of the Medicaid Services Manual Issued April 15, 2012 Claims/authorizations for dates of service on or after October 1, 2015 must use the applicable ICD-10 diagnosis

More information

Getting Paid for Hospice Physician Services: Covered Activities and Roles

Getting Paid for Hospice Physician Services: Covered Activities and Roles NHPCO has contracted with physician-billing expert, Acevedo Consulting Inc., to develop a range of resources to help members navigate the recent and forthcoming changes in physician billing under the federal

More information

end-of-life decisions Honoring the wishes of a person with Alzheimer's disease

end-of-life decisions Honoring the wishes of a person with Alzheimer's disease end-of-life decisions Honoring the wishes of a person with Alzheimer's disease Preparing for the end of life When a person with late-stage Alzheimer s a degenerative brain disease nears the end of life

More information

DEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE

DEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE 1 DEPRESSION CARE PROCESS STEP EXPECTATIONS RATIONALE ASSESSMENT/PROBLEM RECOGNITION 1. Did the staff and physician seek and document risk factors for depression and any history of depression? 2. Did staff

More information

You can relax, knowing your final wishes will be respected.

You can relax, knowing your final wishes will be respected. Memorial Fund You can relax, knowing your final wishes will be respected. Humana Financial Protection Products GNA06XOHH 11/09 MI Memorial Fund Ensure financial peace of mind for you and your family. You

More information

Service delivery interventions

Service delivery interventions Service delivery interventions S A S H A S H E P P E R D D E P A R T M E N T O F P U B L I C H E A L T H, U N I V E R S I T Y O F O X F O R D CO- C O O R D I N A T I N G E D I T O R C O C H R A N E E P

More information