Day One:The Medicare Benefit and Conditions of Participation

8:30 - 9:00 Introductions and Overview

9:00 - 10:45 Medicare Benefit: Clinical Aspects
- Philosophy/premise of the benefit
- Determining what is covered/uncovered
- Eligibility and recertification
- Levels of care
- Attending, consulting and hospice physicians
- Contracted facilities
- Revocation, discharge (including the Expedited Review Process) and transfer
- “Who else is watching?” (OIG, State, HIPAA, JCAHO, CHAP)

10:45 - 11:00 Break

11:00 - 12:00 Group Exercise: Problem Solving Case Scenarios

12:00 - 1:00 Lunch

1:00 - 1:30 Making the Case for Eligibility: Admission, Care and Recertification at all Levels of Care
- Technical denials
- Local Coverage Determinations
- Eligibility standards
- Narrative notes
- Signature “Do’s” and “Don’ts” Documentation of consulting physician involvement
- “Chart-Killers”/“Chart-Savers” Documenting for payment
-Progressive Corrective Action process

1:30 - 2:30 Professional Case Management in Facilities
- Coordination of care
- The Plan of Care and documentation
- Responsibilities of the hospice and the facility

2:30 - 2:45 Break

2:45 - 3:45 Conditions of Participation: Technical
- Date and time deadlines
- Definition of IDT
- Rules related to the Plan of Care
- Basic eligibility, informed consent

3:45 - 4:15 Supporting General Inpatient and Continuous Levels of Care
- Explanation of the guidelines
- Demonstrating eligibility
- Changes to the care plan

4:15 - 5:00 Group Exercise: Would You Pay? Case Scenarios

Day Two:The Interdisciplinary Team and the Process of Care Planning

9:00 - 10:00 Interdisciplinary Team Functioning
- Case management
- Communication
- Collaboration
- The role of each discipline
- Barriers to effective team functioning
- “Multi” vs. “inter” disciplinary teams
- Identifying the “softer” problems and goals
- Determining visit frequency – under and over-visiting

10:00 - 10:30 Hierarchy of Hospice Functioning

10:30 - 10:45 Break

10:45 - 12:00 The Compliant and Meaningful IDT Meeting
- Barriers to effective IDT meetings
- The care planning process
- Meeting agenda
- Case presentation
- Problems/goals/interventions
- Care plan review and revision
- Role of facilitator

12:00 - 1:00 Lunch

1:00 - 2:00 IDT Meeting Role Play

2:00 - 2:30 Creating a Culture of Eligibility

2:30 - 2:45 Break

2:45 - 4:00 Quality Assessment and Performance Improvement and the Team
- Overview of QAPI
- Breaking it down: outcomes and you
- Documenting assessment and measurement
- QAPI and the plan of care
- QAPI meets the IDT: activating quality
- Improvement for each patient/improvement for all patients

4:00 - 5:00 Questions, Post Test and Evaluations