The Hospice Times They Are A-Changin….

One of my favorite nuns in high school often called me "bold" (a frequent nun term) and accused me of taking too much pleasure in "starting revolutions."  For this blog post, allow me to be bold and describe a revolution I see occurring in the hospice industry.  I did not start it, I don't even take pleasure in it - but I want to name it.

By | February 15th, 2015|6 Comments

Part II. Appreciative Inquiry and the Certification Process…Imagine That! Discovery and Dream

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By | December 17th, 2014|1 Comment

Part III. Appreciative Inquiry and the Certification Process…Imagine That! Design and Destiny

Through collaborative thinking, the team chooses innovative processes that are in alignment with both the strengths identified in Discovery and the imagined hopes of the future (Dream).  

By | December 17th, 2014|Comments Off on Part III. Appreciative Inquiry and the Certification Process…Imagine That! Design and Destiny

Part 1: Appreciative Inquiry and the Certification Process… Imagine that!

Every hospice physician has experienced difficulties in assessing “gray” patients. These are the ones who, at admission, do not have a principal diagnosis or terminal story that leaps out from the record, although for many of these patients, the physician is able to answer “no” to the “would you be surprised if your patient dies within the next six months” question. 

  • Are these patients truly terminally ill?
  • Is a period of seeming stabilization sustainable?
  • Should these patients be evaluated for discharge due to extended prognosis?


By | November 27th, 2014|3 Comments

In Hospice, Every Day is Election Day

What does hospice have in common with political campaigns besides elections? Unfortunately, more than you'd think. It's not to late to reverse course and return to the days when journalists, patients/families, and referring physicians were promoting the benefits of hospice. Our colleague Kathy Brandt explores these similarities and ways each hospice can work to repair the reputation of hospice.

By | October 30th, 2014|Comments Off on In Hospice, Every Day is Election Day

Back to the “Definition Board:” Defining Terminal Illness

The Medicare Hospice Benefit has always defined the terminal illness, not as a single diagnosis, but as the interplay of conditions that together cause an individual to have a prognosis of 6 months or less.  At this point, the proposed definition is open for comments. However, my guess is that in the final determination there may well be a clear differentiation between the definition of ‘terminal illness’ and that of the ‘principle/hospice-qualifying diagnosis’ to better underscore the prognostic implication and comprehensive nature of the former.

By | October 20th, 2014|1 Comment

Keep Calm…and Prepare for IMPACT – Part 1

The passage of the 2014 IMPACT Act will bring more survey's to hospices. In this first of two blog posts, Joy Barry details what hospices need to do now to prepare for more frequent surveys of a hospice’s compliance with the Medicare Conditions of Participation (CoPs).

By | September 25th, 2014|Comments Off on Keep Calm…and Prepare for IMPACT – Part 1

Will the Impact Act really help the hospice industry?

Am I a party pooper?  A Debbie Downer? You can decide, but I don't think the hospice provisions in the Impact Act of 2014 are going to do much to increase transparency, sort out the "good"  hospices from the "bad," or, sadly, improve the quality of care provided by hospices. Let me explain...

By | September 21st, 2014|2 Comments

The New IOM Report on Dying in America

The publication of the  Institute of Medicine's 2014 report  on Dying in America offers a significant opportunity to elevate the challenges of caring for people with advanced serious illness. Since hospice is the only Medicare benefit designed specifically for "the dying" and so many Americans are accessing hospice hours or days before they die, the issue of timely access to hospice care must be addressed.

By | September 18th, 2014|Comments Off on The New IOM Report on Dying in America