Regulatory and Compliance
To maintain compliace, a hospice patient's plan of care must be reviewed and updated by the IDG at least this often.
What is 15 days?
This objective nutritional marker, documenting unintentional loss of this minimum percentage of body weight over the preceeding 6 months, strongly supports decline.
What is 10%?
October 1, 2026
What is the date hospices must start sending service addendums to all patients?
During which benefit period does a patient require a face to face?
I had a hoarder patient who had live mouse traps which she would have me take outside. One day one of the mice escaped and jumped on my shoulder.
Who is Kayla?
If admission documention is delayed, who do I notify in order to remain compliant with the Notice of Election?
Who is billing? NOE must by sent within 5 calendar days.
The admitting nurse does not feel the patient meets criteria for hospice. Their next step should be this.
What is call their manager?
The timeframe a hospice has to provide the service addendum to patient/caregivers?
What is 5 calendar days after admission and 3 days for any non-covered changes after that?
Symptom follow up visits must be completed by this day after a HOPE assessment and for these symptoms.
What is 2 days and moderate to severe?
I onced missed a visit because my patient called to let me know their pet snake had escaped from his cage and they did not know where it was.
Who is Angie?
The Notice of Medicare Non-Coverage must be given how many hours before discharge?
What is 48 hours?
A patient meets many, but not all, of the disease specific LCD criteria. What other documentation/info could help demonstrate the patient's overall clinical picture still supports hospice enrollment?
What are combitidies and functional decline?
The addendum must clearly list items, services, and drugs that the hospice determines to be this.
What is non-covered or not related to the terminal diagnosis?
I need to do this if I admit a patient to hospice to home health.
What is communication admission to HH team so they can discharge the patient? PS Yes, it can be the same day.
Who is Emily?
Continuous care hours cannot start after what time?
What is 4pm?
For a pulmonary patient, this objective measurement (often from a pulmonary function test) being at or below 30% is a strong indicator of eligibilty.
What is FEV1?
These are required to be included on the service addendum.
What are terminal diagnosis and related comorbidities?
Certification of terminal illness must be given within how many days before admission?
What is 14 days?
Who is Angie?
Hospice aides must complete this many hours of in-service training per 12 month period to maintain their compliance and competency requirements?
What is 12 hours?
Repeating patient narratives forward in clinical notes without showing this key element can trigger a compliance audit or Immediate Jeopardy.
What is evidence of ongoing clinical decline/progression?
Failure to provide the addendum within mandated timelines results in this financial penalty for the hospice.
What is non-payment?
This is the number of times a patient may transfer to a different hospice during each benefit period.
What is 1?
During COVID, I had to help wheel a dead patient to the parking lot because the funeral home was not allowed in the building.
Who is Emily?