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Interdisciplinary Conference Preconference Seminars

Preconference Seminars (Saturday, September 16 and Sunday, September 17)

Community‐Based Palliative Care: Getting Started
Community‐Based Palliative Care: Making It Work
On‐Ramps, Off‐Ramps and Unexpected Intersections: Navigating Transitions in Palliative and Hospice Care
GIP: Eligibility, Documentation, Risk
Crafting a High Performing Team: The Art of Successful Team Development
Regulatory and Compliance Update for Physicians and Advance Practice Nurses
Moving WAY Beyond Assessment and “Support:” Critical Counseling Skills and Interventions for Social Workers, Chaplains and Bereavement Professionals
Stars in your Future: Linking Hospice CAHPS Results and Billing Data for a Winning Quality Combination

PC1: Community‐Based Palliative Care: Getting Started
Saturday, September 16
1:00 – 5:00 pm

Joanna Bennett, Acevedo Consulting Inc, Delray Beach, FL
Kathleen Kerr, Healthcare Analytics, Mill Valley, CA
Sue Lyn Schramm, MA, NHPCO, Alexandria, VA
Judith Skretny, NHPCO, Alexandria, VA

This fast‐paced and interactive seminar is for anyone who is beginning or thinking about beginning a community‐based palliative care program. Program delivery models will be described as will the basics of developing a business plan and creating a budget. Participants will learn about reimbursement opportunities for palliative care provision.

If you want to be sure that you have all of your community‐based palliative care “ducks in a row,” don’t miss this seminar.

Learning Objectives:

  • List three critical questions to ask before offering palliative care
  • Describe two models and locations of palliative care service delivery
  • Discuss reimbursement for palliative care services

PC2: Community‐Based Palliative Care: Making It Work
Sunday, September 17
8:30 am – 5:00 pm

Lori Bishop, BSN, RN, Sutter Care at Home, Fairfield, CA
Joanna Bennett, Acevedo Consulting Inc, Delray Beach, FL
Torrie Fields, MPH, Blue Shield of California, San Francisco, CA
Suzi Johnson, MPH, Sharp Healthcare, La Mesa, CA
Kathleen Kerr, Healthcare Analytics, Mill Valley, CA
Sue Lyn Schramm, MA, NHPCO, Alexandria, VA
Judith Skretny, NHPCO, Alexandria, VA
Terri Warren, MSW, Providence TrinityCare Hospice, Torrence, CA

This seminar will provide a deep‐dive into strategies for making community‐based palliative care programs a success. Participants will learn strategies for contracting for revenue, the importance of developing quality metrics that matter to payers, how to maximize fee for service reimbursement and opportunities afforded by alternative payment approaches.

There will be an opportunity to learn from programs that have been successful in sustaining and growing community‐based palliative care services.

Learning Objectives:

  • Discuss the importance of quality‐based data for community‐based palliative care success
  • Describe two revenue sources for palliative care beyond Medicare Part B
  • List two proven success strategies when providing community‐based palliative care services

Sunday, September 17, 9:00 am – 12:00 noon

Morning Preconference Seminars

PC3: On‐Ramps, Off‐Ramps and Unexpected Intersections: Navigating Transitions in Palliative and Hospice Care

Joan K. Harrold, MD, MPH, FACP, FAAHPM, Hospice & Community Care, Lancaster, PA
Mary Lynn McPherson, PharmD, MA, MDE, BCPS, CPE, University of Maryland School of Pharmacy, Stevensville, MD
Brooke Worster, MD, Thomas Jefferson University Hospital, Philadelphia, PA

Patients with progressive illnesses undergo many transitions during the course of care. Palliative care may accompany life‐prolonging interventions. These may begin to merge with end‐of‐life conversations when there is ambiguity about outcomes, change in the balance between benefits and burdens or full consideration of a change in goals.

These transitions are often gray areas, not clearly defined changes in clinical conditions or treatment plans. Patients and families may find it natural to have mixed goals, wanting directions of care that are equally gray. Join the conversation as a palliative care physician, hospice and palliative pharmacist, and hospice physician use real‐life clinical situations to talk about these transitions and treatment plans; learn how to improve the patient/family experience and ensure excellent quality of care is provided during transitions.

Learning Objectives:

  • Describe common challenges when patients have mixed goals and treatment plans during transitions related to cancer, heart disease, chronic lung disease, renal disease, dementia, and old age with multiple diagnoses
  • Discuss coordination and communication strategies that can help palliative care and hospice teams work together to better support patients and families wrestling with transitions in expectations and care
  • Devise strategies for management of treatment trials, expectations, and costs during clinical transitions

PC4: GIP: Eligibility, Documentation, Risk

Patricia M. Gibbons, BSN, Greensboro, NC (invited)
Jennifer Kennedy, RN, MA, CHC, NHPCO, Alexandria, VA

Government scrutiny of GIP usage continues with concerns regarding eligibility and documentation for each day, areas for which all hospices are vulnerable and where scrutiny is increasing. This seminar will provide guidelines for determining eligibility and examples of documentation as well as identify risk areas that all hospices should be monitoring.

Learning Objectives:

  • Discuss GIP eligibility and identify associated risk areas
  • Discuss documentation requirements and identify associated risk areas
  • Identify strategies to reduce hospices’ vulnerability to scrutiny of their GIP usage

PC5: Crafting a High Performing Team: The Art of Successful Team Development

Sarah McKinnon, MA, Seasons Hospice Management Inc, Rosemont, IL

The core of the provision of hospice and palliative care is the team. Across the globe in survey after survey, team management consistently lists in the top five challenges leaders face today. A recent Amazon search on team development yielded over 24,000 resources. Building and sustaining a high performing team takes work. It is important to understand that while all teams are groups, not all groups are teams. In this seminar, we will identify what it takes to turn your ‘group of individuals’ into an engaged and results‐producing team!

Learning Objectives:

  • Assess your team’s current state, desired future state, and what it would take for you to develop and sustain a high performing team
  • Discuss the difference between teams and work groups using seven key distinctions
  • Define five key competencies required for a leader of a high functioning team and list practical tools to develop your proficiency in each

Sunday, September 17, 1:30 – 4:30 pm

Afternoon Preconference Seminars

PC6: Regulatory and Compliance Update for Physicians and Advance Practice Nurses

Judi Lund Person, MPH, CHC, NHPCO, Alexandria, VA
Shaida Talebreza, MD, AGSF, FAAHPM, HMDC, University of Utah School of Medicine, Salt Lake City, UT

The regulatory and compliance issues for hospice medical directors and hospice physicians continue to be complex and a daunting array of regulatory requirements. This seminar will cover compliance with the Medicare/Medicaid Hospice Conditions of Participation; regulations regarding certification and recertification of terminal illness; and determining conditions, treatments and medications and relatedness to the terminal prognosis. In addition, the seminar will include late‐breaking discussions about the role of the attending physician and the hospice’s responsibility in contacting and communication. The survey process and the latest survey deficiencies will be discussed, as well as opportunities to use quality improvement processes to improve survey findings and clinical operations. Finally, the latest areas for hospice scrutiny and what CMS Center for Program Integrity, the Office of Inspector General and the Department of Justice are seeing in hospice investigations will be covered.

Learning Objectives:

  • List three requirements for the certification of terminal illness and relatedness determinations
  • Identify two issues with attending physician involvement that have recently been discussed by CMS, the MACs and NHPCO
  • Discuss three areas of hospice scrutiny identified by the OIG and DOJ

PC7: Moving WAY Beyond Assessment and “Support:” Critical Counseling Skills and Interventions for Social Workers, Chaplains and Bereavement Professionals

Gary Gardia, MEd, LCSW, CT, Gary Gardia Inc, Alto, NM

We know that Medicare requires that we provide “counseling” but there is some confusion about what that entails and sometimes even confusion about who the counselors are. Since we are not “diagnosing” or providing psychotherapy, what does counseling mean in terms of the provision of hospice care? What techniques and/or theoretical frameworks can we use and for what specific dynamics? Also consider this thought: are physicians and nurses solely responsible for pain and symptom management , which then means that only social workers can address the psychosocial goals?

The answer is of course not; not if we are providing true interdisciplinary care. Hey wait! What do we do about scope of practice!?

This seminar will address these topics and other common challenges. We will explore ways to “raise the bar” for the provision of counseling via the interdisciplinary team, specifically focused on the work of

social workers, chaplains and bereavement professionals. We will discuss, in depth, the evidence‐based theoretical frameworks that are best suited to hospice care. Each will be applied to specific examples and common hospice situations. No more documenting “Provided emotional support”! With ever shortening lengths‐of‐stay, we have to get down to work quickly in order to ensure people have their best possible hospice experience.

Learning Objectives:

  • Discuss common misconceptions about the concept "scope of practice" as it applies to the provision of interdisciplinary care
  • Explain the application of Motivational Interviewing techniques to specific hospice examples
  • Apply three Cognitive Behavioral Therapy techniques to an example of faulty thinking in a hospice caregiver

PC8: Stars in your Future: Linking Hospice CAHPS Results and Billing Data for a Winning Quality Combination

Carol D. Spence, PhD, NHPCO, Alexandria, VA
Joan M. Teno, MD, MS, Cambia Palliative Care Center of Excellence ‐ University of Washington, Seattle, WA

Public reporting – aka Hospice Compare ‐ has arrived and will soon include the Hospice CAHPS measures.  Hospice Compare ratings can affect an organization's reputation and market share, and eventually may be used to determine reimbursement. That makes it imperative for hospices to do everything within their power to ensure that they are achieving the best Hospice CAHPS scores possible.

This seminar will provide practical advice on how to analyze CAHPS scores for improvement opportunities, to identify trends, to compare your CAHPS scores to national benchmarks and other organizations, and to recognize the key service delivery issues for the unique population that you serve. How to use visit billing data to delve under composite scores on the CAHPS survey will be discussed and performance improvement case studies focused on Hospice CAHPS measures will be presented as well.

The clock is ticking. The time is now to take action to maximize performance on Hospice CAHPS.

Learning Objectives:

  • Interpret Hospice CAHPS measure scores at the hospice and national levels
  • Analyze Hospice CAHPS results using multiple data sources
  • Formulate a strategy for developing performance improvement projects related to Hospice CAHPS measures