Prescribing cascades and inappropriate medication use are especially harmful to patients with a serious illness. Risks are compounded as patients age. This webinar, presented by AvaCare, will explore rational prescribing and deprescribing as part of good prescribing. Tools for evaluating medication appropriateness in geriatric patients and patients with serious illnesses will be reviewed. Special consideration will be given to over the counter (OTC) medications.

Objectives:
1- Explore rational prescribing and deprescribing
2- Review available tools for evaluating medication appropriateness
3- Discuss OTC utilization and recommendations in the aging, seriously ill population

The number of hospice patients with a cardiovascular diagnosis listed as the principal diagnosis is on the rise. Heart failure patients electing hospice present unique challenges. Medication management after the hospice election may necessitate multiple medication changes. During this presentation, Dr. Ellen Fulp from AvaCare will review heart failure disease progression, identify common issues facing end-stage heart disease patients, and review pharmacologic and non-pharmacologic management options for heart failure patients. Additionally, this webinar will review potential regulatory issues associated with medication selection and payment for heart disease patients. 

Hospice clinicians are not routinely prepared to engage in shared decision making to manage complicated medication profiles after hospice election. Hospice medication lists are often stagnant and do not reflect the changing status of terminally ill patients. This is evidenced by the drug profile being commonly cited on survey deficiencies. Hospices are facing increased regulatory scrutiny surrounding medication profiles after hospice election. These include Medicare Part D leakage and inappropriate medication billing and payments as referenced in 2019 OIG reports and new election statement addendum requirements. 

Objectives:
• Discuss medication appropriateness and rational prescribing
• Review “relatedness” and IDT member roles in ensuring hospice compliance
• Identify key medication-related regulatory updates and concerns facing hospice providers
• Analyze the “Patient Notification of Hospice Non-Covered Items, Services and Drugs” addendum

In the FY 2020 Hospice Wage Index Final Rule, CMS finalized the new requirements for the election statement and an election statement addendum detailing the items, services, or drugs the hospice will not cover. CMS has determined that this information is necessary for patients and their families to have in order to make informed care decisions. During this informative webinar,
Judy Morris from 5 Star Consultants will explain the changes to the Hospice Election Statement and discuss in detail the new requirement for the election statement addendum. Join us to be sure your agency is prepared to comply with the new requirements effective October 1, 2020.

The number of hospice patients with a respiratory diagnosis listed as the principal diagnosis is on the rise. Chronic Obstructive Pulmonary Disease (COPD) patients electing hospice present unique challenges. Medication management after hospice election may involve multiple medications and formulation changes. This presentation will review COPD disease progression, identify common issues facing end-stage COPD patients, and review pharmacologic and non-pharmacologic management options for COPD patients. Additionally, this webinar will review potential regulatory issues associated with medication selection and payment for COPD patients. 

This presentation will review the basic information hospice providers need to know about using methadone as an analgesic for patients living with a serious illness. We will briefly discuss pain assessment and will identify appropriate methadone candidates. This webinar will also discuss the appropriate methadone use, follow-up, and monitoring during hospice care.

Objectives:
1. Discuss the history of methadone
2. Review types of pain and basic pain assessment
3. Discuss the risks and benefits of methadone use
4. Describe the appropriate use of methadone in the hospice population
5. Review dosing and monitoring strategies for methadone

This webinar will review pain assessment and hospice quality measures surrounding pain management during end-of-life care. Additionally, we will differentiate nociceptive and neuropathic pain and identify the appropriate therapies based on clinician assessments. We will review formulary analgesic selection and safe opioid regimen initiation, rotation, and titration.

Objectives:
1. Review pain and pain assessment
2. Discuss hospice quality measures surrounding pain management at end-of-life
3. Differentiate nociceptive and neuropathic pain
4. Identify appropriate analgesic therapies based on clinician assessments
5. Review formulary opioid regimen initiation, titration, rotation, disposal and monitoring

This webinar will review medication appropriateness and the concept of deprescribing for seriously ill patients. Cases will be presented to highlight the need to reevaluate risks vs. benefits of medications over time. This program will also review how to apply available literature to patient cases and communication tips for success.

Objectives:
-Briefly review the concept of medication appropriateness
-Define and discuss deprescribing
-Identify common nonessential medication classes for seriously ill patients
-Discuss effective communication tips for having difficult deprescribing conversations

Although the importance of coding in Hospice took on such an important role about 5 years ago, many Hospice agencies are still unsure about the coding guidelines for hospice.

The FY2020 ICD-CM final code set includes 273 new, 30 revised and 21 deleted codes as well as 98 Tabular Instruction changes

This session will focus on a review of the coding guidelines for hospice. In addition, we will also review the October 2019 coding updates, focusing on changes and challenging coding regulations.

This webinar will review practical tips for ensuring your patients’ medication regimens are optimal for seriously ill patients. We will review medication selection, identifying nonessential medications, and how to safely discontinue medications for seriously ill patients. This program will also address formulary medication selection for seriously ill patients with commonly occurring symptoms. Lastly, we review the concept of "relatedness" as patients transition to the hospice benefit.
Objectives:
-Examine medication appropriateness and rational prescribing
-Identify medications that are appropriate for cost-effective symptom management
-Review common classes of non-essential medications and how to safely discontinue them
-Determine hospice drug coverage when given patient-specific information, including diagnosis codes and terminal prognosis

Branch Offices/Multiple Locations and Corporate Entities: Survey Implications for Home Health and Hospices

There has been an increase in survey deficiencies in both home health and hospice related to branch offices/multiple locations and how operations are handled. There are also increased survey deficiencies related to how home health agencies and hospices with corporate entities, whether large or small, are handling daily operations. These deficiencies are often at the condition level and come as a surprise to the provider as many have been operating in much the same way for years without deficiencies. This webinar will review the practices that are causing the deficiencies, why they are now being viewed as a deficient practice, and how to revise practices to minimize the risk of survey deficiencies. Examples from actual surveys will be shared.

Preparing for an Initial or Renewal Hospice Accreditation Survey

Join Clinical Compliance Educator, Lisa Meadows, as she discusses preparing for an initial or renewal hospice accreditation survey.

ACHC Top Hospice Survey Deficiencies

Join Clinical Compliance Educator, Lisa Meadows, as she goes over the ACHC Top Hospice Survey Deficiencies.

Preparing for Initial Hospice Medicare Certification Survey

Join Clinical Compliance Educator, Lisa Meadows, as she discusses preparing for survey for Initial Hospice Medicare Certification.

Download slides here.

After Survey: Developing a Plan of Correction for Hospice

Join Lisa Meadows as she discusses Developing a Plan of Correction (POC) after your ACHC Hospice survey.

The Role of Volunteers in Hospice

This presentation will review the regulatory requirements for the utilization of volunteers in hospice programs as well as discuss tips for survey readiness.

Download slides here.

Hospice Documentation: Painting the Picture of the Terminal Patient

Hospice documentation has recently come under scrutiny by CMS through both ADRs and UPIC/ZPIC. It is becoming more apparent that rock solid hospice documentation is the only way to prevent recoupment of hospice dollars. Its one thing to say that a patient is terminal, but another to prove it in documentation. This webinar is a bare bones, back to basics approach to hospice documentation.

Download the slides here.

Distinction in Palliative Care 

ACHC has recently released a new Distinction in Palliative Care that allows ACHC accredited home health, hospice or private duty agencies to earn additional accreditation for their palliative care program. Join us as we review what palliative care is, the ACHC Distinction in Palliative Care Accreditation Standards, and how this new distinction can benefit your agency!

Download slides here.