Services performed by qualified personnel: Nursing, MSW, Physician, HHA, and Physical Therapy. Also included are the drugs, DME, & supplies related to the terminal dx.
What are Covered Services?
100
A ________________ is a period in which the individual requires continuous care to achieve palliation or management of acute medical symptoms.
What is a Period of Crisis?
100
The Medicare fixed payment categories.
What are routine, inpatient, continuous, & respite?
100
These services are not based on a per diem basis, they are reimbursed based on a fee scale.
What are physician services?
100
The maximum amount of cash a hospice can receive from Medicare during a period that runs from November 1st to October 31st.
What is the Aggregate CAP?
200
Medical supplies are included as a covered service IF it is included in this document.
What is the Plan of care?
200
The terminology for continous care at HPNI
What is Crisis Care?
200
The name of the Medicare Service that reimburses hospice.
What is the fiscal intermediary (FI)?
200
The federal fiscal year for Medicare payments.
What is October 1st through September 30th?
200
This does not allow total GIP patient-days to exceed 20% of total Medicare days.
What is the Inpatient CAP?
300
The discipline that is required to perform the general supervision of a HHA.
What is a Registered Nurse?
300
The minimum hours of care that must be furnished in a day to qualify for continuous care (crisis care)
What is 8 hours?
300
The minimum proportion of nursing time needed in order to be reimbursed for continuous (Crisis Care)
What is 50%?
300
Services not considered hospice care are paid for by ___________.
What is the individual?
300
These are the types of payments from Medicare that are counted when calculating the CAP amount.
What are all Medicare payments?
400
_________________ perform household services to maintain a safe and sanitary environment in areas of the home used by the patient, such as changing bed linens or light cleaning and laundering essential to the comfort and cleanliness of the patient.
What is a Home Health Aide?
400
Short-term inpatient care provided to the individual only when necessary to relieve the family members or other persons caring for the individual.
What is Respite care?
400
Reimbursement rates for patient transfers are based on ____________.
What is where the patient ends their day?
400
Level of care where the patient receives pain control or acute or chronic symptom management which cannot be managed in other settings.
What is the general inpatient level of care?
400
___________ times CAP Rate = Aggregate CAP
What is Medicare admissions?
500
The 3 covered services that are provided for purposes of symptom control or to enable the patient to maintain activities of daily living and basic functional skills.
What are PT, OT, and speech-language pathology?
500
Respite care may be provided only on an occasional basis and may not be reimbursed for more than ____________ consecutive days.
What is five?
500
The reimbursement rate for patient care is determined based on _____________________________.
What is where the service is provided?
500
The terminology used to define the amount of money needed to equal the difference between the cap set in the Budget and the amount actually appropriated by Congress.
What is Sequestration?
500
______ (number of admissions) X $6,500 (CAP Rate) = $1,300,000 (Aggregate CAP).