In The News

Hospice Services Pulled for Dementia Patient

I got a letter about a hospice agency ending services for a woman whose only diagnosis was dementia . As sad as I am to hear those stories (and I get many) I am not surprised. These families have had the comprehensive services of hospice for months, even a year or so and then they are  withdrawn because the person is no longer eligible.

These discharges are happening because dementia doesn’t play by the rules for end of life. It isn’t until eating becomes a problem that the dying process really begins. 

Dementia seems to be in a category of its own. It doesn’t fit into Home Health services that focus on getting people better. It doesn’t really fit Palliative Care, although maybe it could. 

There is a huge void in our medical system that so many families living with dementia fall into. These families have a loved one too sick and require too much care without hope of getting better. Yet because they have not yet entered the dying process they do not qualify for most health care services, let alone hospice care…

Hospice, to its credit, has stepped in to fill this void, but is tied by the six month prognosis clause in the hospice medicare benefit. If they can’t report continued decline toward approaching death after 6 months of care they must discharge a person from services.

If you find yourself in the situation where your special person is being discharged from hospice due to not declining fast enough, have the hospice social worker advise and help you get into community services that are available in the area. Check national resources like AARP. Services that can help support you in the loving care you are giving.

Ask about where you can get medical equipment, assistance in physical caregiving, even volunteer support. Also check end of life doulas in your area. Talk to them, see what they can offer and how much they charge. What about support from a church? Also some places now have dementia doulas. Do an internet search to see if any are in your area.

None of the above will be as comprehensive as the services hospice has provided, but use the hospice social worker while you have her/him.

 

Participate in the 2023 HCP Benchmarking Report

Every year, HCP performs the largest annual study on the home-based care industry and publishes the results as the HCP Benchmarking Report. The Report is used by hundreds of agencies to learn best practices, analyze their performance, and make more informed decisions.

This year for the first time, the Report will include data on home health and hospice to promote industry alignment, improve outcomes, and help address the need for whole-patient care.

The Report relies on agencies like you to contribute by taking the survey that supplies this valuable data. You will also find valuable insights into your own business as you reflect on your 2022 data in preparation for the survey. 

As a survey participant, you won’t just be helping the industry, you will also receive a free digital copy of the 2023 Benchmarking Report (usually $999) and 50% off a hard copy if you complete the survey by January 31.

Learn more about this year’s Report and get started on the survey at https://www.homecarepulse.com/benchmarking/.

 

Use the myCGS Eligibility Tab to Avoid Claim Errors

CGS

It’s a new year and the perfect time to add one more resolution to your list! Before you submit a claim, use the myCGS eligibility tab to avoid these simple errors:

  • Eligibility – Is your patient eligible to receive services covered under the Part A, Part B or Part B Immunosuppressive Drug benefit?
  • Deductibles/Caps – Has your patient met the annual Part B deductible, therapy cap or rehabilitation services limitation?
  • Preventive Services – Is your patient eligible to receive a service that Medicare covers to prevent certain illnesses and chronic conditions?
  • Plan Coverage – Did your patient enroll in a Medicare Advantage (MA) managed care plan that replaces traditional Medicare?
  • MSP – Is your patient entitled to other insurance coverage that makes Medicare a secondary payer (MSP)?
  • Hospice/Home Health, Inpatient – Did you provide services to your patient that overlap a hospice or home health period of care, or an inpatient hospital or Skilled Nursing Facility stay covered under Part A?

Stop the guesswork and eliminate the need to submit multiple claims. myCGS is a FREE, online web portal available to ALL CGS J15 providers. Register and use myCGS today to save your organization time and money!

 

Colorado (Again) Changes Rules on How Employers Must Compensate Employees Using Paid Leave

Littler Publications | Dec 20, 2022

Effective January 1, 2023, regulations under Colorado’s Healthy Families and Workplaces Act (HFWA) will again change how employers calculate the rate of pay when employees use paid sick and safe leave and/or public health emergency leave. Although employers might welcome certain changes to the pay rate calculation rules, the fact is that these new regulations amount to the third time that Colorado’s Department of Labor & Employment (CDLE) has revised the pay rate calculation rules since the HFWA first took effect in mid-2020. Thus, pay rate calculations under the HFWA are a moving target, making compliance a challenge. Learn More

 

Biden Administration Renews Public Health Emergency Again

Full text of the declaration reads:

As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19)  pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective January 11, 2023, the January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, and that I renewed on April 15, 2021, July 19, 2021, October 15, 2021, January 14, 2022, April 12, 2022, July 15, 2022, and October 13, 2022, that a public health emergency exists and has existed since January 27, 2020, nationwide.

 
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