by editor | Dec 8, 2024 | Blog, Keys to Compassionate Care
Reopening of prior year CAP calculations is always difficult to manage and is one of the dreaded letters that you may receive any year. It’s difficult enough to manage CAP during a given CAP year, but you also need to efficiently estimate CAP for patients who move between hospice providers so that you can estimate your risk of CAP overage and associated estimated overpayments.
The OIG released an audit of CGS’ cap calculation process for the 805 hospices that operated in CGS’s jurisdiction. Of these, 61 had net cap overpayments totaling $9.1 million for cap year 2020.
As part of the audit, the OIG reviewed the templates used to calculate aggregate cap amounts and selected 45 hospices to determine whether CGS followed its processes and whether the calculations in the templates were accurate.
The audit identified that CGS accurately calculated the initial 2020 cap amounts for all 805 hospices and collected or attempted to collect the $9.1 million in cap overpayments in accordance with CMS requirements.
For the the 45 selected hospices, the audit revealed that CGS did not reopen and recalculate most hospice caps for prior cap years (i.e., 2017, 2018, and 2019) resulting in lost collections of overpayment for these prior years. (CAP calculations may be reopened for up to three years.)
As a result, the OIG recommended actions that would increase CGS’ compliance with the policy of reopening prior year CAP calculations.
Hospice agencies operating in the CGS jurisdiction should take note of the results of this audit as it will likely result in increased identification of CAP overpayment demands in upcoming years.
For Additional Information
Link to full OIG report: https://tinyurl.com/ym3vu3ez
Video: Hospice CAP and key indicators for hospice CAP risk
by editor | Mar 24, 2024 | Blog, Keys to Compassionate Care
In recent years, there has been a growing interest in exploring alternative therapies for patients in hospice care, and one such option that has gained attention is the use of marijuana. This controversial topic raises important questions about the potential risks and benefits associated with integrating marijuana into end-of-life care. In this blog, we will delve into the complexities surrounding marijuana use in hospice settings, considering both the potential advantages and drawbacks.
Benefits of Marijuana in Hospice Care
- Pain Management: One of the primary reasons marijuana is considered in hospice care is its potential to alleviate pain. The cannabinoids in marijuana, particularly THC and CBD, have been shown to have analgesic properties, providing relief for patients grappling with chronic pain associated with terminal illnesses.
- Appetite Stimulation: Patients in hospice care often face challenges such as loss of appetite and weight loss. Marijuana has been known to stimulate appetite, commonly referred to as the “munchies.” This effect can be particularly beneficial for patients who struggle with maintaining a healthy weight during their final stages of life.
- Nausea and Vomiting Control: Cancer treatments and certain illnesses can induce severe nausea and vomiting. Marijuana, especially strains rich in CBD, has demonstrated antiemetic properties that can help alleviate these distressing symptoms, improving the overall quality of life for patients.
- Anxiety and Depression Relief: Facing the end of life can be emotionally challenging for both patients and their families. Marijuana has shown promise in reducing symptoms of anxiety and depression, offering a sense of calm and tranquility during a difficult time.
Risks of Marijuana in Hospice Care
- Cognitive Impairment: One of the well-known side effects of marijuana use is cognitive impairment. In hospice care, where maintaining clarity of thought and communication is crucial, the potential for marijuana to cause confusion and memory issues may be a concern.
- Respiratory Issues: Smoking marijuana can have adverse effects on the respiratory system, which is especially problematic for patients with pre-existing respiratory conditions. Alternative methods of consumption, such as edibles or tinctures, may be considered to mitigate this risk.
- Drug Interactions: Marijuana can interact with other medications, potentially altering their effectiveness or intensifying side effects. Hospice patients often take multiple medications, and the introduction of marijuana should be carefully monitored to prevent any adverse interactions.
- Legal and Ethical Considerations: The legal status of marijuana varies globally and even within certain regions. Hospice care providers must navigate complex legal and ethical landscapes when considering marijuana as part of a patient’s treatment plan.
Conclusion
The integration of marijuana into hospice care remains a nuanced and controversial topic, with both potential benefits and risks. While it has shown promise in addressing pain, appetite loss, and emotional distress, concerns about cognitive impairment, respiratory issues, drug interactions, and legal considerations must be carefully weighed.
Open communication between healthcare providers, patients, and their families is paramount to ensure that any decision aligns with the patient’s overall well-being and end-of-life goals. As the landscape of medical marijuana evolves, ongoing research and a compassionate approach to care will help guide its appropriate use in hospice settings.
