Medicare has recently modified eligibility criteria for hospice services effective immediately.
Key changes include:
Medicare no longer accepts claims using the primary diagnosis of debility and decline/failure to thrive, or associated diagnoses (codes 780-799). Supporting documentation must now be submitted with the claim supporting the terminal diagnosis. The question that must be answered is: What is going to take the patient’s life? This determines the terminal diagnosis. Providence Hospice has created a pocket guide with the new Medicare guidelines and a score sheet to help you determine hospice eligibility. When referring, please use this guide to determine diagnosis or reasons for debility. Include all supporting co-morbid conditions contributing to the patient’s disease trajectory.
Providence Hospice staff is available to assist with any questions you may have regarding hospice referrals or to deliver hard copies of any of the attached tools. For assistance please call our office at 541-732-6500. On-call staff is available after hours and on weekends, as needed. We appreciate your partnership as we navigate these changes. We look forward to serving you, your patients and their families.
Download the Hospice pocket guide
Download the Hospice guidelines tip sheet
Providence is committed to palliative care and addressing the needs patients in the Columbia Gorge. Thanks to a two-year, $170,000 grant from the Cambia Foundation, Providence can now care for more patients through the development of a comprehensive palliative care program.
Providence Hospice of the Gorge will be featured at the annual National Palliative Care Congress for their innovative program that provides palliative care and end-of-life education to the Latino community.
The new Modified Early Warning System, or MEWS, was launched at Providence Medford Medical Center in mid-July. The primary purpose of MEWS is to ensure swift intervention or transfer of critically ill patients, resulting in lower morbidity and mortality for our patients. Using a computer algorithm that runs behind the scenes, MEWS monitors vital signs and pages the unit charge nurse if a patient’s score reaches a specified threshold. Nurses then reassess the patient, notify the attending physician and follow a response-and-monitoring protocol. This automated alert comes directly from the electronic health record system currently in place at PMMC.
With help from a Cambia Health Foundation grant, Providence Medford Medical Center is expanding its palliative care program to provide the full continuum of care. The interdisciplinary team is led by Medical Director Susan Kohler, M.D., and consists of a palliative care nurse practitioner, case managers and spiritual care chaplains. Providence currently offers palliative care on an inpatient and outpatient basis. The grant provides funding to expand the program and to help educate patients, families and physicians on the value of this extra support.