Current

Resources

Find all Current Resources from 2022 below. 

November 2022

November FYI

FYI 22.11

Coming Soon

November TOT

TOT 22.11

Coming Soon

Subscriber Webinar

Friday, November 11, 2022

Hospice and Palliative Care Legal Considerations and Updates

The Hospice OIG reports issued over the past few years as well as concerns regarding patient care and fraud have led to statutory and regulatory changes and increased governmental scrutiny of hospice and palliative programs. This session will address some of the changes that have been made, the current state of governmental auditing and oversight, and what hospices can expect in the future.

Speakers:

Annette Lee, RN, MS, HCS-D, COS-C

October 2022

October FYI

FYI 22.10: The Hospice PHE Continues

October TOT

TOT 22.10 When Eligibility Is Not So Clear


Subscriber Webinar

Friday, October 14, 2022

Hospice Discharge Doors

CMS brings the final decisions on items proposed for hospices in the proposed rule from this spring, and Hospice Fundamentals brings the recommendations for the prudent hospice for implementation and compliance.

Speakers:

Annette Lee, RN, MS, HCS-D, COS-C

September 2022

September FYI

FYI 22.9: FY 2023 Hospice Wage Index FINAL Rule

The FY 2023 Hospice Wage Index Final Rule was published in the Federal Register on July 29, 2022. Recognizing the intense demands and delays that the COVID-19 pandemic is having on hospices, this
year’s proposed rule is much briefer than in previous years. The great news in this brief rule was that CMS was increasing rates by 3.8% for FY2023. This was 1.19% more than the proposal.

September TOT

TOT 22.9: CARE COMPARE: Where Are Our Updated Measures?

CMS’s website, Care Compare, provides consumers a direct way of reviewing quality data about a hospice before election. Unfortunately, due to the pandemic, there has been a disruption to the quality data reporting- and some will remain “off schedule” until August of 2023! This tool will allow you to track at a glance the timeframes for your public data, and when that data gets updated.

Subscriber Webinar

Friday, September 9, 2022

Final Wage Index Follow Up

CMS brings the final decisions on items proposed for hospices in the proposed rule from this spring, and Hospice Fundamentals brings the recommendations for the prudent hospice for implementation and compliance.

Speakers:

Annette Lee, RN, MS, HCS-D, COS-C

August 2022

August FYI

FYI 22.8: A Sneak Preview of Your Scores! CMS provides a preview of hospice data/scores prior to going “live” on the public “Care Compare” website each quarter. The preview for the November 2022 Care Compare update is available now!

August TOT

TOT 22.8: CMS HOSPICE WAIVERS & EXPECTED END DATES

CMS has provided multiple posibilities through the federal waivers allowed during the Public Health Emergency. Currently the PHE is set to expire on October 13th, but CMS has also promised providers that they would give us a 60-day warning prior to ending the PHE and its waivers. The current waivers, and their end dates are provided below.

Subscriber Webinar

August 12, 2022

When the LCDs Don't Do the Trick

There is certainly an art and a science to prognostication. The MACs have provided some guidelines to all hospices with their Local Coverage Determinations (LCDs). Using these LCDs, whenever it is applicable, to aid in decision making can ensure defensible documentation for terminal prognosis. This session will cover the guidelines, as well as recommendations for creating a culture of compliance, based on the LCDs.

Speaker:

Annette Lee, RN, MS, HCS-D, COS-C

July 2022

July FYI

FYI 22.8: Election Denials Are Increasing – Does YOUR Form Pass CMS’ Test?

The Medicare Administrative Contractors (MACs) are denying hospice medical review audits due to the lack of specifics on the election statement form. CMS has continued to provide guidance and regulatory changes over the last decade on what MUST be in the Election Statement when the patient or representative elect hospice.
Every year for the last several years, hospices and EMRs have been trying to keep up with CMS and the changes while trying to discern what was a mandated change, and what was a CMS “best practice” to provide additional information to patients.

July TOT

TOT 22.8: ELECTION STATEMENT COMPLIANCE

Due to the recent increase in denials related to a missing component in the election statement, use this tool as a checklist to ensure your Prudent Hospice has all of the items on the Election Statement. These items must be on the election form itself, and not just in the patient handbook, or part of another form. The MACs are denying in medical review if a component is missing from the Election Statement itself.

Subscriber Webinar

July 8, 2022

Tapping Into the Talents of Your Music Therapist

Hospice teams often operate as multi-disciplinary, with each team member contributing their expertise to help achieve an optimal end of life experience. This month, we’ll be exploring ways that music therapists can apply their unique skillsets to enhance the patient experience and interdisciplinary collaboration. Music therapists can support the documentation of eligibility, support roles of other disciplines, improve patient quality of life, and increase overall family satisfaction . We will be discussing strategies for integrating hospice music therapists for the benefit of the patient and family, the hospice team, and the hospice as an organization.

 

Speakers:

Rebecca Perez, Music Therapist & Chris Acevedo, CHC, Principal, Hospice Fundamentals

June 2022

June FYI

FYI 22.6: CMS HOPE Testing

Attention- CMS Needs YOU!  Hospices are being asked to volunteer to be a part of the development of our next data collection and assessment tool.  Hurry- the door closes after June 30th.  Please see this FYI for details!

You can get all of the details by clicking on the link below.

June TOT

TOT 22.6: Plan of Care Tool

This TOT is just in time after a great Summer Conference where we talked at length on assessment and care planning.  This tool will provide a guide to walk through the care planning process- and how to assess if your process is working– and not just “checkboxes”. 

You can download the tool by clicking on the links below.

May 2022

May FYI

FYI 22.5: Know Your CMS Data

It is imperative in today’s climate to know your agency’s risks. CMS has provided several ways in order to see your hospice agency’s data. This gives your agency a way of knowing how CMS views you—both from a quality perspective- and if you are an “outlier”- at risk for audit- due to billing information. This FYI will provide you with the tools to review your own data.

You can get all of the details by clicking on the link below.

May TOT

TOT 22.5: The Four Paths to Elligibility 

Below is one of our most popular tools, The Four Paths To Eligibility. All four paths lead to the same destination: identification and support of a six-month prognosis. Given how long it’s been since we released it, we wanted new subscribers to be aware of it and we wanted to remind veteran subscribers that it is still a valuable resource.

You can download the tool by clicking on the links below.

Subscriber Webinar

May 13th, 2022

Wage Index, PEPPER Data and Quality Reporting Updates

Hospices across the nation eagerly await the Proposed Rule for information on changes to regulatory requirements and reimbursement, and the opportunity to provide comments to CMS. We’ll review and discuss the provisions of the proposed rule and, from the musings in the narrative, try to discern what is on the mind of CMS. CMS provides free benchmarking payment data in the PEPPER report. This year the report features some new metrics. Review the trends in the established data benchmarks, as well as the new data being provided to the industry. It should be noted that this data is used by auditors, including the Medicare Administrative Contractor (MAC) and certainly should be used by all prudent hospices.

Speaker:

Annette Lee, RN, MS, HCS-D, COS-C

April 2022

April FYI

FYI 22.4: FY 2023 Hospice Wage Index Proposed Rule

The FY 2023 Hospice Wage Index Proposed Rule was published in the Federal Register on April 4, 2022. Recognizing the intense demands and delays that the COVID-19 pandemic is having on hospices, this year’s proposed rule is much briefer than in previous years. It includes a 2.7% rate increase for hospices on October 1, 2022.

You can get all of the details by clicking on the link below.

April TOT

TOT 22.4: Social Determinates of Health (SDoH) REFERENCE TOOL

In this year’s proposed wage index rule, CMS requested information from hospices about how they are addressing health equity.  CMS’ intention is clear that they are addressing inequities throughout the healthcare system.  It’s difficult to really understand the different things that can affect care within our agencies, without the data to show it.  One way we can track data is by the ICD-10 codes that look at the social determinants of health. Many of these determinants can certainly make care more difficult or less accessible, and it’s important to see at your agency, and across the hospice industry, what are the most common barriers amongst our populations.  This tool will get you started on how to code for these issues.

Download the tool by clicking on the link below.

Subscriber Webinar

April 8th, 2022

ICD-10 Coding: The Implications of Social Determinants of Health

Whether hospice or palliative care, diagnosis coding helps to support the medical necessity of your services. As diagnosis coding becomes more important than ever, the code set now includes a growing number of codes describing Social Determinants of Health. We’ll start with a short refresher on proper ICD-10 coding and review the expanding list of SDoH ‘Z’ codes. At the end of this webinar attendees should have an understanding of how diagnosis codes “paint a picture of the patient” to the payer, and the impact SDoH codes play in supporting complexity.

Speaker:

Jean Acevedo, LHRM, CPC, CHC, CENTC, AAPC Fellow, President, Acevedo Consulting, Inc

March 2022

March FYI

FYI 22.3: SNF 5 Star Measures

SNF Five Star Measure specifications have been updated in 2022. The technical specifications show that when a resident in the facility is receiving hospice, the SNF is protected from a negative outcome on their fivestar measures.

Get all of the details by clicking on the link below.

March TOT

TOT 22.3: The Path Of The Prudent Hospice

This tool will be used by the prudent hospices to marry together the real world at their hospice, in the context of regulation and government expectations. This tool helps the hospice align their culture, values and mission with the regulations, and provide vision on how to ensure alignment.  This is especially necessary in today’s world of additional upcoming scrutiny of our compliance by CMS.

Download the tool by clicking on the link below.

Subscriber Webinar

March 11h, 2022

Medical Necessity of Physician Visits

While physician services are indeed separately billable above and beyond the daily hospice care rates, the rules governing these payments are often misunderstood. This in-depth webinar will navigate the underlying requirements of medical necessity when providing these services in hospice. In addition to discussing routine medical services we will explore coupling these services with the Medicare required face-to-face encounter and cover the relevance of Advance Care Planning and other non-traditional coding and billing opportunities.

Speaker:

Chris Acevedo, Principal, Hospice Fundamentals

February 2022

February FYI

FYI 22.2: Changes in the Hospice Transfer Process

CMS is introducing new billing instructions when a hospice is involved in a patient transfer. This change will no longer allow there to be a gap in time between two hospices who are transferring care from one to the next. In the future, the date of the end of the prior hospice claim must end on the same date as the beginning of the new hospice’s initial claim.

Get all of the details by clicking on the link below.

February TOT

TOT 22.2: All Aboard the Transfer Train

Transfers have been a tricky area and can put compliance at risk. Adding to this complexity is a new billing requirement, which will be initiated on July 5, 2022. This tool provides clarity regarding CMS’ expectations for transfers in hospice in operations and billing.

Download the tool by clicking on the links below.

Subscriber Webinar

February 11th, 2022

Daily Operations that Reduce Risk!

This session takes a deeper dive, using the platform we started on last month regarding medical review audits. This month, we will take those standards, and look at how our day-to-day operations can increase your risks in audit, or support your compliance and secure your payment! We will look at everything from intake, to assessments, IDG processes and the discharge plan, and how quality of care and operations will overlap survey and payment. This is a “can’t miss session” as we provide the “real world” takeaways that you can start applying at your agency today!

Speaker:

Annette Lee, RN, MS, HCS-D, COS-C, Hospice Fundamentals

January 2022

January FYI

FYI 22.1: Nationwide Hospice Review by OIG

The OIG announced last week the plan to perform a large national review and report on the hospice industry in FY 2023. This review may begin soon, and we may all expect to be a part!
 
Get all of the details by clicking on the link below.

January TOT

TOT 22.1: Top 10 Audit Mistakes

Since the OIG announced that there will be a national hospice audit, most of us are beginning to plan our own internal audit strategy for the year. This tool will help Prudent Hospices to be mindful of their internal goals when doing audits, and to avoid the pitfalls that make audits lose their effectiveness.

Download the tool by clicking on the links below.

Subscriber Webinar

January 14th, 2022

A Day in the Life of a Hospice Medical Review Nurse

Ever wonder how an auditor reviews your records? In this session, a former Medical Review Nurse will describe, in detail, how your hospice records are reviewed when you have an ADR, or other payment audit. A checklist and hierarchy will be provided. So, you can challenge yourself to the test of medical review, before the auditors do!

Speaker:

Annette Lee, RN, MS, HCS-D, COS-C, Hospice Fundamentals

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