Purpose

To help our hospice Medical Directors improve their documentation on certifications of terminal illness in order to capture the prognosis of six months or less. To further enhance our nurses’ knowledge of how co-morbidities interact at end of life to ensure the best possible care of complex hospice patients.

Learning Objectives

Medical Director Education

• Assess a patient’s condition in such a way as to determine if it is chronic as opposed to terminal.
• Document a terminally ill patient’s prognosis of six months or less in such a way that establishes clear eligibility for hospice care.
• Appraise the effects of how multiple diseases interact with each other to contribute to the patient’s overall decline.
• Accurately distinguish whether a hospice patient’s diagnosis is related or unrelated to the terminal diagnosis, and clearly document same. 
• Determine which medications are related or unrelated to the terminal diagnosis, and effectively document how the determination was made.
• Measure eligibility as accurately as possible using multiple diagnostic tools in conjunction with each other.
• Identify factors to review and document for the face-to-face encounter that either support ongoing eligibility, or indicate a chronic/custodial phase.

Achieving these objectives will help the Hospice Medical Director more effectively lead and guide the inter-disciplinary team in providing the appropriate level of care for the right patient at the right time. This in turn will help ensure that Care Initiatives Hospice is being a responsible steward of Medicare dollars.

RN Case Manager Education

• Interpret how multiple diseases in one patient interact to contribute to the patient’s symptoms, behaviors, and overall decline.
• Distinguish the difference between when a disease is advanced versus end-stage.
• Identify appropriate diagnostic tools (lab tests, etc.) for use in determining a patient’s appropriateness for hospice care.
• Interpret the Local Coverage Determination criteria for hospice eligibility.

Achieving these objectives will help the hospice Nurse Case Manager more accurately identify patients who are appropriate for hospice care, and improve their skill level in managing symptoms of complex patients with multiple comorbidities.

Agenda