This program, presented by Corridor powered by WellSky, covers the Conditions of Participation in detail, including the Medicare benefit from a clinical perspective including eligibility, recertification, what is covered and what is not, levels of care, revocation, discharge and transfer.

Throughout the program, focus is placed on documentation throughout the continuum of care, including documentation regarding eligibility, levels of care, symptom management and the Local Coverage Determinations (LCDs).

In addition, the Comprehensive Assessment and the “rules” surrounding the Plan of Care. Significant focus will be placed on the interdisciplinary Group (IDG) including their form and function and the IDG meeting.

Facility based care is also highlighted in this program to assist in understanding the importance of care coordination and both the hospice and the facility responsibilities. 

The Hospice Quality Reporting Program is explained including the proposed new process measures and the Hospice Outcomes and Patient Evaluation (HOPE) tool.
 
Objectives of Hospice Nuts and Bolts:

• Understand the basics related to the Hospice Conditions of Participation 
• Define key components of the Medicare Hospice Benefit 
• Identify documentation requirements regarding: 
• Eligibility 
• Initial & Comprehensive assessment 
• Certification & Recertification 
• Plan of Care 
• Levels of Care
• Understand the form and function of the IDG 
• Define the elements of the HQRP and impact on your agency
• Understand the SNF – Hospice agency coordination of care

Faculty:

Sharon Seaton, RN, BSN, CHPN, HCS-O, HCS-D CCS-HH
Sharon Seaton spent most of her career in varied roles in Home Health and Hospice with experience in clinical and senior management, as well as experience in Quality & Compliance in both for-profit and non-profit organizations.

As an Executive Director her organization was awarded the “Hospice of the Year” designation for growth and quality scores. She also was the recipient of a Rotary International grant for rural hospice care. She has also worked as a Quality Assurance Reviewer for Home Health diagnosis and OASIS coding and Hospice Coding Services.

Currently, she is a Program Manager at Wellsky. Sharon has been a featured speaker at conferences across the U.S. showcasing both Hospice and Home health quality and compliance.
 


Program Curriculum

Day One

8:30 8:45 Introductions and Introduction to Program
8:45 10:15 The Hospice Medicare Benefit

• Philosophy of the Hospice Benefit
• Core Services
• Determining What is Covered
• The Role of the Ordering Providers(s)
• Face to Face

10:15 10:30 Break
10:30 12:00 Conditions of Participation: Clinical Aspects

• Patient Rights
• Initial and Comprehensive Assessment
• Coordination of Services
• IDG and Care Planning

 
Day Two

8:30 8:45 Painting the Picture (Activity)
8:45 10:45 Making the Case for Eligibility

• Targeted Probe and Educate (TPEs) and ADRs
• Documentation and Demonstrating Eligibility
• The Local Coverage Determination Guidelines
• Supporting Prognosis: Making the Case Every Time
• Assessment Prompts
• Documenting Pain
• Discharge and Revocation

10:45 11:00 Break
11:00 11:30 Case Study – Dementia
11:30 12:00 Diagnosis Coding and Documentation

• What is Diagnosis Coding and Why is it Important?
• Why Accurate Coding is Essential
• Ensuring Your Comprehensive Assessment Gathers the Necessary Information for an Accurate Claim
• Terminal Diagnosis and Related Conditions
• Prohibited Primary Terminal Diagnoses

Day Three

8:30 9:45 Interdisciplinary Group and The Plan of Care

• Case Study — IDG Decision Making
• Barriers to Effective IDG Meetings
• The Care Planning Process
• Meeting Agenda: Roles and Responsibilities
• Individualizing the POC
• The Role of the Hospice Physician

9:45 10:00 Break
10:00 11:00 Facility Based Care

• Coordination of Care
• The POC and Documentation
• Roles and Responsibilities
• Relationship Building
• The Inpatient Unit and GIP

11:00 11:15 Case Study – Coordination of Care
11:15 12:00 Proof of Excellence: HQRP, HOPE

• Building a Culture of Compliance
• Hospice Quality Reporting Program
• Hospice Outcomes and Patient Evaluation tool (HOPE)
• Timely Reassessment of Pain Impact
• Timely Reassessment of Non-Pain Symptom Impact