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Hospice Conditions: Related vs. Unrelated

presented by Beth Noyce, RN, BSJMC, HCS-C

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Disclosure Statement:

Financial: Beth Noyce receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.

Non-Financial: Beth Noyce has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Video Runtime: 30 Minutes, Learning Assessments: 30 Minutes

Despite CMS's repeated attempts to persuade hospices to cover virtually all care needed by hospice patients, agencies continue, in CMS's view, to cherry-pick patient conditions as related versus unrelated to the terminal prognosis rather than follow CMS guidance. Hospices allow too many services and supplies related to the terminal prognosis to be charged to Medicare sources outside the hospice benefit, as well as to the hospice patients themselves. This course is recommended for all nurse case managers, hospice physicians, and administrators, as well as all interdisciplinary group members who participate in planning patient care. Participants will gain perspective concerning the repeated admonition that virtually all care of terminally ill patients should be covered by the hospice. Patient specificity and agency policies are both at play, and agencies will learn to balance these competing forces according to CMS rules.

Meet Your Instructor

Beth Noyce, RN, BSJMC, HCS-C

Beth Noyce, RN, BSJMC, HCS-C, is a home health and hospice consultant, mentor, educator, and regulatory Jedi who helps agencies know when they are at risk. She draws on her varied leadership and patient care hospice and home health experience gained since 1997. Job description? She helps keep people out of trouble. Beth was executive…

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Chapters & Learning Objectives

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1. First: The Terminal Prognosis

Chapter 1 will clarify CMS’s definition of terminal prognosis to prepare agencies to determine what conditions are related versus unrelated thereto. CMS’s definition of terminal prognosis requires that hospices cover virtually all care of hospice patients due to the beneficiaries’ waiver of other Medicare benefits when electing the hospice benefit. Get some documentation tips, and learn why hospices are experts at relatedness.

2. Related vs. Unrelated Conditions and Treatments

Learn to accurately classify patient conditions and treatments as related versus unrelated to the terminal prognosis. Chapter 2 provides examples from CMS showing common errors, including those that involve nonhospice spending, and the risks of OIG scrutiny. Gain increased appreciation for the importance of the interdisciplinary approach to care, including documentation tips. Get an overview of the history and context for CMS’s updates to the election statement and the addendum to the election statement, as well as the content of those two documents.

3. A Scrutiny-Resistant Process

Learn to develop and implement agency policy/procedure to determine which conditions, for each patient individually, are related versus unrelated to the terminal prognosis. Ensure that your process shows you base your decisions on policy, not on the cost of individual treatments. See how one large agency’s process works to identify hospice conditions that are related versus unrelated to the terminal prognosis.

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