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continued from previous page The Complex Case Format There are four primary steps in this process: 1. Gather Information Obtain the past and current medical information about the patient, but also identify family dynamics, the decision-makers, caregivers and spokesperson, as well as what the patient and the family expects and wants. 2. Inform All Involved Advise the patient and family of what to expect from us, including timeframes and specifics such as the name and phone number of their hospice contact person. It’s also equally important to make sure that all staff who will be providing the care have the pertinent information about the patient and family. 3. Conduct a Complex Case Conference Oftentimes conducted as a conference call, this meeting should present and discuss the case, and ultimately determine if the hospice should admit or not admit the patient to service. Thus, it’s essential that all necessary parties take part in the meeting, such as the certifying physician; MD or ARNP who will be attending the patient; RN who has been coordinating the admission; social worker and/or chaplain; admissions manager; manager of the receiving team and/or designee; and any specialty staff (e.g., respiratory or infusion therapist). 4. Debrief After the high-intensity portion of the patient’s care is accomplished, have the same people who participated in the conference reconvene to assess and identify what went well and what changes might be needed in future complex cases. At Chapters, we not only follow these steps when admitting a new patient with complex needs, but also when an existing patient’s care becomes complex. By including all of the players in the discussion—patient, family and staff—everyone understands what is expected, each other’s role and function, and how the pieces work together. This level of coordination helps to reduce anxiety and empowers staff to make wise decisions. The process itself can be likened to that of an orchestra, where planning and communication ensure a harmonious outcome. Of course, the demands and available resources for each hospice may be quite different, so this format is really only meant to be a starting point for your organization, not a “one size fits all” solution. continued on page 4 2 NewsLine
Important Points About the Proposed FY2014 Rule The Centers for Medicare and Medicaid Services released a proposed rule (posted by CMS on April 29 and published in the Federal Register on May 10) which would update the fiscal year FY2014 hospice reimbursement rates. But that wasn’t all. There were a number of other important things addressed that all providers should be aware of, including: clarification on coding requirements; hospice quality reporting; an update on hospice payment reform options; a shortstay add-on payment; rebasing the routine home care rate; a site of service adjustment for hospice patients in nursing facilities; and a cost report analysis. Given this, please be sure to review the information that our Regulatory Team makes available. A good place to start is with the NHPCO Regulatory Alert issued on April 30. One particular point that concerns me greatly is the claim from CMS that under the proposed rule hospices would receive “a 1.1 percent market basket increase” in their reimbursement. As I shared in a message to members when the proposed rule was posted, the numbers don’t add up. The impact of sequestration cuts was not calculated in this figure. Under current law, the CMS proposed payment update would actually mean a minus 0.9 percent decrease for the nation’s hospice community. Please be assured that NHPCO, the Hospice Action Network and our lobbyists are all working to emphasize the damage that a negative update would bring to the hospice community. Furthermore, our official letter to CMS will be submitted by the July deadline for comments. Hospices are already struggling with an increased regulatory burden, heightened scrutiny, and existing productivity cuts. Given the value that hospice brings to the federal system and the patients and families we serve, we must work collaboratively and carry our unified voice to Capitol Hill. There is also a part you can play. The Hospice Action Network will be hosting its annual Advocacy Intensive in Washington, DC on July 29 and 30, 2013. We need to bring as many advocates as possible to the nation’s capital to carry our voice to members of Congress. And every voice matters—hospice directors, clinical staff, volunteers, board members and supporters! Registration is now open, so please consider joining us. J. Donald Schumacher, PsyD President/CEO NewsLine 3
Page 1: The Monthly Membership Publication
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Page 9 and 10: The Complex Case Format Courtesy of
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Page 13 and 14: The Guidelines in Practice Staffing
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Page 21 and 22: NHPCO would like to thank all the c
Page 23 and 24: BAYADA Hospice • Moorestown, NJ T
Page 25 and 26: What you don’t know can hurt you
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Page 29 and 30: attendance at APTA and NHPCO confer
Page 31 and 32: Advertisement HEALTHCARE CONSULTANT
Page 33 and 34: 2014 Circle of Life Award: Call for
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Page 37 and 38: New Online Courses from NHPCO’s E
Page 39 and 40: SPRING 2013 Hospice Patient and Vet
Page 41 and 42: Lighthouse of Hope Fund Provides Me
Page 43 and 44: Run to Remember: A Look at Two Spec

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