Hospice 101 - Nurses

Home Healthcare Workers and Violence in the Workplace

The world of hospice care is deeply personal and profoundly compassionate. As a hospice clinician, your primary focus is providing compassionate care to your patients and their families during their most vulnerable moments. But the intimate nature of home-based care can sometimes expose you to unexp

December 7, 2024 · 4 min read

What is a Hospice IDG Meeting and Who Should Attend

The hospice interdisciplinary group (IDG) creates a patient’s plan of care and provides holistic care to the patient, caregiver, and family. Hospice Conditions of Participation require the IDG to “review, revise, and document the individualized plan as frequent as the patient’s condition requires, b

October 13, 2024 · 3 min read

Hospice Interdisciplinary Group (Hospice IDG)

Hospice care is patient- and family-centered, where the patient's and family's preferences and needs drive the care plan. The hospice interdisciplinary group (also referred to as Hospice IDG or IDG), also referred to as the interdisciplinary team (IDT) is a team of healthcare professionals who work

October 7, 2024 · 4 min read

Informative Podcasts from BRG

These interesting and informative podcasts from Berkeley Research Group, LLC were developed for nurse executives. Nurse Executive Podcast The podcasts cover a wide range of interesting and timely topics such as leadership, workplace violence, revenue capture, AI, use of technology, and how to best w

July 29, 2024 · 1 min read

Caregivers: Understanding Burnout and Promoting Resilience

Caregivers play a critical role in hospice care, where the focus is on providing comfort and support to individuals nearing the end of life. These unsung heroes, often family members or close friends, offer physical, emotional, and spiritual support to their loved ones during one of life's most chal

May 10, 2024 · 4 min read

What is a False Claims Act investigation?

What is the False Claims Act

January 29, 2023 · 8 min read

What is the hospice governing body?

What is the governing body? In accordance with the Conditions of Participation, a Medicare certified hospice agency must have a governing body. The governing body has ultimate responsibility for the hospice agency, including legal and financial authority. Medicare Conditions of Participation require

January 29, 2023 · 2 min read

What is a UPIC audit?

What is a UPIC? Unified Program Integrity Contractors (UPICs) are contracted by CMS to conduct detailed medical review, data analysis, and audits of healthcare providers to investigate possibilities of Medicare or Medicaid fraud, waste, and abuse. While the primary purpose of a RAC or MAC audit is t

January 28, 2023 · 8 min read

What is the TPE audit process?

What is a TPE? A Targeted Probe and Educate (TPE) is an audit program that was rolled out by CMS in 2017. The stated goal of this program is to help providers reduce claim denials and appeals. The TPE works to achieve its goal by educating providers in topics that will help to eliminate common [&hel

January 28, 2023 · 3 min read

What is a SMRC review?

What is a SMRC? A SMRC is a Supplemental Medical Review Contractor. CMS contracts with SMRCs to conduct medical reviews for Medicare Part A, Medicare Part B, and DME providers. SMRCs are contracted through the Center for Program Integrity/Provider Compliance Group Division of Medical Review and Educ

January 28, 2023 · 7 min read

What is the Hospice Quality Reporting Program (HQRP)?

What is the purpose of hospice quality reporting? The Affordable Care Act authorized the establishment of a Quality Reporting Program for hospices. The Hospice Quality Reporting Program (HQRP) was established in 2014.  HQRP aims to ensure that the level of quality in clinical care, symptom mana

December 11, 2022 · 3 min read

What is Hospice Item Set (HIS)?

All Medicare certified hospice agencies must submit an HIS Admission and HIS Discharge record on all admissions and discharges from their agency. The report must include all patients, irrespective of payer source, patient age, or location where hospice services were provided. It is recommended that

November 27, 2022 · 3 min read

What is the CAHPS survey?

The CAHPS survey is intended to measure the experience of patients who had died while receiving hospice care and the experience of their primary caregivers.  It surveys informal caregivers – usually family members – of the persons who died under hospice care. The survey is a component of the Ho

November 27, 2022 · 5 min read

What is a hospice PEPPER report?

Program for Evaluating Payment Patterns Electronic Reports (PEPPER) is a data analysis report that has been available for hospices since 2012. This report contains claims data statistics based upon UB-04 claims data submissions for a single hospice agency. The statistics are generated for areas that

November 26, 2022 · 6 min read

Understanding the PEPPER Report

The PEPPER report target areas focus on statistics that will identify potential for improper Medicare billing. Comparison to national, jurisdictional, and state percentiles can highlight a hospice agency’s potential need for change to its practices to guard against improper billing. Hospice agencies

November 26, 2022 · 5 min read

What is Hospice Visits in the Last Days of Life (HVLDL)?

HVLDL is an HQRP claims-based measure of the proportion of patients who have received in-person visits from a registered nurse (RN) or a medical social worker (MSW) on at least two of the final three days of life. This metric replaces the HIS-based measure Hospice Visits When Death is Imminent (HVWD

November 13, 2022 · 4 min read

What is Hospice Care Index (HCI)?

HCI is a single comprehensive metric reflecting ten indicators of care delivered during a hospice stay — from admission to discharge.  This metric, which is included in the patient Care Compare portal, is intended to provide patients, families, and caregivers with an added metric to support inf

November 13, 2022 · 4 min read

Must every hospice participate in the CAHPS hospice survey?

What is the CAHPS hospice survey? The CAHPS hospice survey is administered to eligible caregivers after a patient’s death to measure the quality of care and communication provided by the hospice. A hospice agency must participate in the CAHPS Hospice Survey to be eligible for its full annual payment

November 7, 2022 · 3 min read

Selecting a CAHPS Hospice Survey Vendor

Why should a hospice agency use a CAHPS Hospice Survey vendor? A hospice agency is not permitted to administer its own CAHPS Hospice Surveys. Instead, every hospice agency is required to contract with an approved CAHPS Hospice Survey vendor. The vendor will administer the CAHPS Hospice Survey on an

November 7, 2022 · 3 min read

Hospice Acronym Alphabet Soup

Are you confused by the Acronym Alphabet Soup? Does the never ending list of acronyms used in the hospice and healthcare industry leave you confused? Are you worried that you may confuse CMN with CMP? To help sort out the confusion, we add here links to lists of acronyms: Acronyms commonly found on

September 15, 2022 · 1 min read

What is Face to Face Recertification?

A hospice face to face encounter is a step in patient recertification beginning with the third benefit period and each benefit period thereafter. The goal of hospice face to face patient encounter is to encourage greater involvement of the physician in the care of patients who have been on hospice f

August 4, 2022 · 3 min read

Core Services: Using Employees versus Contractors

Hospice Conditions of Participation – employees versus contractors Hospice conditions of participation require that almost all hospice core services are delivered by hospice agency employees and may not be delivered by contractors. Hospice core services include: Nursing services Social services Coun

August 1, 2022 · 1 min read