Hospice Eligibility, What's that?
Guardrails in Action - Hospice Rules and Regulations
If it's not documented, it's not done
Hospice Best Practice - Not an option
100

This metric is vital to document eligibility for patients admitted with COPD or other terminal respiratory conditions?

What is a room air oxygen saturation?

100

This must be obtained and documented from the Hospice Physician AND the attending physician (if the patient has one) within 2 days of the start of hospice care.

What is the verbal certification of terminal illness?

100

This visit type must be completed and documented between days 6 and 15 after the hospice admission?

HUV#1

100

There are 4 hospice levels of care. It is best practice that a member of the hospice team—such as a nurse, social worker, chaplain, or aide—visits the patient daily during this level of care. 

What is respite?

200

These are examples of incorrect ways to make a correction on an Election of Benefit document.

What is scratching out a date or changing a date after signatures have been obtained, with no additional context or reason provided?

200

These are examples of incorrect ways to make a correction on an Election of Benefit document.

What is drawing a line or scratching through the date and putting an earlier date than what was originally entered, without any additional context, note or information?

200

This documentation strategy related to documenting repetitive or same/ similar notes may save time but should never by used.

What is copying and pasting visit notes or other documentation?

200

To ensure best practice for Speed to Hospice Care, the hospice contacts the patient/caregiver within this amount of time (e.g. minutes, hours, days, months, years?) after a referral is received?

What is 30 minutes?

300

In addition to the current date, these other date/s can be entered for Start of Care.

What is a future date?

300

If the Certification of Terminal Illness is signed by the physician BEFORE the Face to Face encounter is completed Medicare will consider the claim as _______________.

What is Invalid or not billable?

300

We all agree that This documentation strategy improves clarity and supports eligibility in notes.

What is using objective, measurable, and specific language?

300

It is best practice that the patient receives a visit from a nurse within this timeframe after admission.

What is 24 hours?

400

The hospice comprehensive assessment must be updated at least every _______________ days unless by the IDG unless ________.

What is every 15 days unless otherwise required by state rules?

400

This is an example of an incentive or financial/ social support that cannot be offered by a hospice with the intent of gaining a referral, to a discharging patient or to a discharge planner.

What is the statement - we will pay for the ambulance ride home from the hospital.

400

This type of Medicare audit may continue for three rounds if the hospice's documentation does not pass the first round.

What is a Targeted Probe and Educate (TPE) audit?

400

If and when a patient is transferred to the ER, it is best practice the RNCM or on-call RN take this action immediately or as soon as possible, with intent to meaningfully interact with the patient, CG, ER team and avoid a live discharge

What is the best practice of meeting the patient in the ER?

500

This NYHA Classification includes marked limitation of physical activity. The patient is comfortable at rest but less than ordinary activity causes fatigue, palpitation, shortness of breath or chest pain.

What is NYHA Class III?

500

This member of the hospice IDG is responsible for determining relatedness and/or coverage by the hospice.

What is the Hospice physician?

500

Hospice staff are expected to complete these 2 actions at each patient visit.

What is document at the bedside (point of care) and sync their device?

500

The NP or physician completing the Face to Face Encounter should ALWAYS review recent documentation and this coordination/ team related activity _______________________________ before completing the encounter.

What is collaborate with the RNCM to gather information about the patient's current status and any recent changes?