Rules and Regulations - Social Workers

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

Patient Privacy, Confidentiality, and HIPAA Regulations

As a member of the hospice healthcare team, you play an important role in caring for your patients. Because of this, you will often learn private information about them – not just about their health, but also about their personal relationships, their financial situations, and other sensitive and per

August 25, 2024 · 3 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

What is the Hospice Election Statement requirement?

To receive hospice services under the Medicare benefit, a patient or his authorized representative must elect hospice care. If the patient or authorized representative elects to receive hospice care, the patient must file an election statement with a specific hospice agency. The election statement s

October 18, 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