OIG Recommends Greater Scrutiny for Hospice Services Furnished to Patients in ALFs

The evaluation and policy division of the HHS Office of Inspector General (OIG) issued a study dated January 13, 2015 after evaluating all Medicare hospice claims from 2007 through 2012.  If history is a guide, critical OIG studies such as this one trigger additional targeted scrutiny, and so hospices, particularly for-profit hospices, should expect increased hospice audits related to their services to ALF residents. 

By | January 15th, 2015|Comments Off on OIG Recommends Greater Scrutiny for Hospice Services Furnished to Patients in ALFs

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

Years of experience and research have demonstrated that “…people learn, and organizations change most readily when they focus on, study, and engage in dialogue about strengths, patterns of success and who they are at their best."

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

OIG Hospice Audit – Despite Extremely Low Error Rate, OIG Claims Significant Refund Liability on Basis of Extrapolation

The OIG clings to its tenuous position that, even with its concession that CMS will determine the overpayment amount, the hospice was overpaid “at least $447,467.”  This suggests OIG is driven to show Congress that it will continue to “come down hard” on hospices, even those with very low error rates.  

By | November 19th, 2014|Comments Off on OIG Hospice Audit – Despite Extremely Low Error Rate, OIG Claims Significant Refund Liability on Basis of Extrapolation

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