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https://www.cgsmedicare.com/hhh/education/materials/pdf/Hospice_5PTER_FactSheet.pdf
As a condition of payment under the Medicare hospice benefit, the six-month terminal prognosis must be supported in the medical record. The physician’s clinical judgment must be supported by clinical information and other documentation that provides a basis for the six-month prognosis.
https://healthcareprovidersolutions.com/documenting-hospice-eligibility-for-alzheimers-dementia/
Mar 22, 2019 · Documenting Hospice Eligibility for Alzheimer’s Dementia. When admitting a patient to hospice with a primary terminal diagnosis of Alzheimer’s disease, your documentation should clearly show the nature and condition causing the hospice admission in addition to, the hospice disease-specific LCD guidelines.
https://www.cgsmedicare.com/hhh/education/materials/pdf/hospice_documentation_tool.pdf
Documentation to Support Hospice Services with Examples of Possible Quantifiable Values/Measures Documentation need only include that information that is specific to the patient being assessed. Examples may include: •Change in patient’s weight (pounds, kilograms) •Worsening diagnostic lab results (increase, decrease) •Change in pain - Type (ache, throb, sharp)
http://www.hhvna.com/files/CorporateCompliance/Education2016/Hospice2016/2-9-16_Hospice_Nursing_Documentation_Supporting_Terminal_Prognosis_Presentation.pdf
Hospice Poor Documentation to Support Terminal Prognosis Documentation reviewed for 10/1/2015-10/31/2015 shows: Hospice admission weight was 82.5 lbs. (hospital weight 85 lbs.) Has poor appetite Appears thin, clothes are loose fitting Totally dependent for all ADLs Incontinent of urine and feces Nonconversive
https://s3.amazonaws.com/GentivaUniversity/JobAids/Hospice+Eligibility+Documentation+Tips+and+Strategies.pdf
1 Page Hospice Eligibility Documentation Tips and Strategies 2 HOSPICE ELIGIBILITY DOCUMENTATION TIPS AND STRATEGIES HOSPICE DOCUMENTATION REQUIREMENTS: The hospice clinical record must support the plan of care and …
http://cchospice.org/wp-content/uploads/2015/09/Eligibility-Determination-Documentation-Joan-Harold.pdf
small cell CA may be demonstrated to be hospice eligible with less documentation than a chronic lung disease patient. Patients with chronic diseases, long term survival in hospice, or apparent stability can still be eligible for hospice benefits, but sufficient justification for a less than six month prognosis should appear in the record .
https://cdn.ymaws.com/www.ahpco.org/resource/resmgr/Files/NoyceHanduts.pdf
• Clinical documentation must support life expectancy of 6 months if the physician-identified terminal illness runs its normal course. Support ICD-9 diagnoses • Cancer diagnoses • Amyotrophic Lateral Sclerosis • Heart Disease • HIV Disease • Liver Disease • Pulmonary Disease • Chronic Renal Failure • Stroke • Coma Support ...
https://c.ymcdn.com/sites/www.nmahc.org/resource/resmgr/Docs/Diane_Datz_-_NMAHCH_August_2.pdf
Analyze clinical documentation to determine appropriate patient diagnoses ... a hospice patient with a terminal diagnosis of lung cancer might receive inhalants ... state that there is no LCD to support the diagnosis, and that the patient is eligible for hospice as evidenced by
https://www.accreditationuniversity.com/media.ashx/hospice-webinar-painting-the-picture.pdf
The Hospice Nurse needs to document a baseline ADL at the time of admission and then with each nursing visit. Point out any changes in ability of the patient to manage ADL’s. This is also a very good indicator of decline. When a nurse is admi#ing any hospice patient, it is also good to document what
https://www.compassus.com/healthcare-professionals/determining-eligibility/hospice-eligibility-for-heart-failure-chf-and-other-cardiac-diseases
Hospice Eligibility for Heart Failure (CHF) and other Cardiac Diseases. These guidelines are a tool to support a physician's best clinical judgement for hospice eligibility. A patient not meeting these guidelines may still be eligible for hospice due to comorbidities or rapid functional decline.
https://palliative.stanford.edu/home-hospice-home-care-of-the-dying-patient/common-terminal-diagnoses/
Common Terminal Diagnoses and Medical Criteria for Referral to Hospice Care Common terminal conditions and the medical criteria indicative of advanced illness. Patients are eligible for hospice only if all of the following conditions are satisfied.
http://cdn-ci33.actonsoftware.com/acton/cdna/4185/f-89691fa0-c32f-4b36-bdcf-6cefcce9bcf1/0/0
Determining Terminal Status •Documentation certifying terminal status must contain enough information to support terminal status upon review. •Re-certifications require same Clinical Standards are met as certification. •Documentation must paint a picture of why the patient is appropriate for Hospice and the Level of Care provided.
https://cdn.ymaws.com/www.ahpco.org/resource/resmgr/Files/NoyceHanduts.pdf
• Clinical documentation must support life expectancy of 6 months if the physician-identified terminal illness runs its normal course. Support ICD-9 diagnoses • Cancer diagnoses • Amyotrophic Lateral Sclerosis • Heart Disease • HIV Disease • Liver Disease • Pulmonary Disease • Chronic Renal Failure • Stroke • Coma Support ...
https://oregonhospice.org/media/CBNursingSupportingTerminalProgApril2017.pptx
Hospice diagnosis (suggested) Statement the patient will be admitted into hospice care (suggested) Documentation. Definition of Nursing. ... Poor Documentation to Support Terminal Prognosis. Calvin is an 88 year male with a diagnosis of Parkinson's. Start of care date was 08/10/2016. Documentation reviewed for January 1-31, 2017 shows:
https://www.compassus.com/healthcare-professionals/determining-eligibility/eligibility-criteria-for-stroke-or-coma
Patients will be considered to be in the terminal stage of stroke or coma if they meet the following criteria. Criteria 1 and 2 are important indicators of functional and nutritional status and will support a terminal prognosis for patients with diagnosis of stroke. Number 3 will lend support.
http://www.hospicebythebay.org/resources/lcd-and-physician-letter-3-15-16.pdf
Referring eligible patients to hospice sooner after a terminal diagnosis augments the excellent care ... How to Estimate a Six-Month Prognosis . A patient is eligible for hospice when 1) he has less than six months to live, and 2) he chooses to ... Documentation of the following factors will support eligibility for hospice care: a. Progressive ...
https://calhospice.org/included/docs/education/2013/conference/3E.pdf
Determining hospice primary diagnoses Once the terminal diagnosis has been established, documentation must support it. The MACs have reported insufficient documentation to support the terminal diagnosis as the top reason for hospice claim denials.
https://cdn.ymaws.com/www.nehospice.org/resource/resmgr/imported/3PrinciplesofHandout.pdf
supporting ongoing hospice eligibility; 2. Explain requirements related to recertification of terminal illness; and, 3. Identify ways to minimize the risk of non-compliance and non-payment. LCD For Determining Terminal Status (L13653) • “…documentation certifying terminal status must contain enough information to support
https://c.ymcdn.com/sites/www.nmahc.org/resource/resmgr/Docs/Diane_Datz_-_NMAHCH_August_2.pdf
Hospice Hot Topics: Determining Appropriate Diagnosis, Hospice Item Set (HIS), Part D Reimbursement Diane Diane Datz, RN, MADatz, RN, MA ... a hospice patient with a terminal diagnosis of lung cancer might receive inhalants ... state that there is no LCD to support the diagnosis…
https://www.selectdata.com/wp-content/uploads/2014/11/Hospice-Documentation-in-the-Hot-Seat-Slides-2-per-page.pdf
And 39% of hospice claims denied are due to the diagnosis code not supporting the terminal illness, said Walker, director of CMS’s Division of Medical Review and Education.”-Home Care Week, 2012: Vol 21, Number 14. “About 40% of hospice claims denied are due to documentation failing to support the terminal illness” REGULATIONS AND AUDITORS
http://www.kshomecare.org/resources/Documents/Education/KHCAHospiceHandouts.pdf
• Once the terminal diagnosis has been established, documentation must support it. The MACs have reported insufficient documentation to support the terminal diagnosis as the top reason for hospice claim denials. Correct Use of Manifestation Codes • As per the Official ICD-10-CM coding guidelines, certain conditions have both
https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Downloads/hospice-provideroverview-booklet.pdf
Documentation supported long-term or custodial care rather than hospice care;[17, 18] and The principal hospice diagnoses on the claims were adult failure to thrive, dementia, and debility.[19, 20] Federal regulations for the Medicaid hospice benefit defer to Medicare hospice …
https://www.supercoder.com/coding-newsletters/my-homecare-week-alert/medical-review-shore-up-your-terminal-illness-documentation-coding-115255-article
Apr 13, 2012 · About 40 percent of hospice claims denied are due to documentation failing to support the terminal illness, explained Latesha Walker with the Centers for Medicare & Medicaid Services at the National Association for Home Care & Hospice's annual March on Washington conference.
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/Hospice/Medicare_Hospice_Data
The table also shows that the frequency of some hospice terminal diagnoses has changed over time, with relatively fewer cancer patients and relatively more non-cancer patients as a percentage of total hospice patients. Lung cancer has been recognized as the most common diagnosis among Medicare hospice patients every year since 1998.
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