Friday, July 13, 2018

PCHETA Call to Action!

The Palliative Care and Hospice Education and Training Act (PCHETA) passed a procedural hurdle today and was reported out from the House Energy and Commerce Committee to the full House of Representatives for its consideration. 

This means it is on its way to being scheduled for a vote! We need you to Take Action Now to request a timely scheduling of the vote, and to ask your Representative to vote YES. 

Click here to be taken to our PCHETA Action Center, where you can make a phone call, send an email, and post social media messages urging the House to act quickly to schedule and pass PCHETA.

Thank you to the many, many advocates and organizations who have worked tirelessly for years to see this legislation through the process. We are so close, won't you take a few minutes to help us over the finish line?

Thank you for your dedicated advocacy on behalf of patients and families nationwide. We really can do amazing things when we all work together. Now, let's pass PCHETA.

Tuesday, July 10, 2018

Be the Cheetah on the Right

I recently had the pleasure to take a bucket-list trip to South Africa with my family. Ostensibly, I was there to attend a board meeting of the Worldwide Hospice Palliative Care Alliance in Durban. Of course, I had to take the opportunity to travel around this magnificent country. I was humbled by the massive disparities between rich and poor in Durban and simply awestruck by the wildlife at the Cape of Good Hope and the power of the Zambezi River and Victoria Falls.

However, no moment was as impactful as the one I captured in the photograph above. The guide explained how rare it is to see a cheetah, let alone to see four gathered in one place. But what was most amazing about this moment came from what you can’t see. To the left of the adolescent cheetahs sits an airstrip. Three of the cheetahs are transfixed by an airplane and activity on the runway—much like my own kids. The cheetah on the right has her siblings’ backs, both literally and figuratively. She is not letting herself get distracted and appears acutely aware of the hungry predators lurking in the distance off camera, including a pride of lions and a female leopard.

As I study the cheetahs today, I wonder if we are at a similar inflection point in our own world. Do we clearly see the threats and opportunities?  We tend not to focus enough on the actual threats that are lurking just beyond what is easy to see and feel, but that which surrounds us and divides us. Tax status, geography, medical specialty, discipline, political persuasion—these are the distractions that the cheetahs on the left obsess over. The cheetah on the right is looking a bit further out, worried about real threats and actively planning to turn future threats into opportunities.

As I reflect on this scene, I am struck by many of the insights that Michael Burcham shared with us during his plenary presentation at April’s Management and Leadership Conference. He addressed some of the disruptors that are affecting all health care providers– many of those involving technology. Based on his experience, he shared concerns that we as a field are missing important signals that are playing out in front of us right now. For those not able to attend the last MLC, Michael’s plenary presentation, TheFuture of Healthcare, is available to the membership free-of-charge on NHPCO’s E-OL , our online learning portal.

Additionally, Michael is serving on NHPCO’s Advisory Council – a new group of experts and thought-leaders that pulls from both within and outside of our professional community. So we will continue to benefit from his knowledge and experience.

I love this picture because of what it says about life—both personally and professionally. Love each other, don’t obsess over the immediate crisis, and look a bit further out to get some perspective. In this one moment, I feel a bit more clarity about our mission here. Let the ones whose aim is not rooted in person-centered, interdisciplinary care be the cheetah on the left. Through all of our differences and challenges let us be the cheetah on the right.

By Edo Banach, JD
President and CEO
National Hospice and Palliative Care Organization

Friday, June 29, 2018

PCHETA Mark-Up in the House of Representatives

The Palliative Care Hospice Education and Training Act (PCHETA) was advanced by the House of Representatives Energy and Commerce Committee Subcommittee on Health on June 27, 2018.
PCHETA (S. 693 and HR.1676) was first developed by NHPCO, the American Academy of Hospice and Palliative Medicine, and the Hospice and Palliative Nurses Association and is now embraced by 53 organizations through the Patient Quality of Life Coalition.

This bipartisan, bicameral legislation would provide palliative medicine training in a variety of settings, including hospice.  PCHETA will also establish a program to enable hospice and palliative physicians to train teams of interdisciplinary healthcare professionals in palliative and hospice care techniques. Additionally, PCHETA will expand the types of professionals trained to provide hospice care, including nurses and clinical social workers. Learn more about PCHETA.

As a hospice and palliative care advocate, it is imperative that you continue to call and email your Members of Congress in the Energy and Commerce Committee regarding this legislation.
PCHETA is sponsored in the Senate by Senators Tammy Baldwin (D-WI) and Shelley Moore Capito (R-WV).  In the House of Representatives, Congressmen Eliot Engel (D-NY), Tom Reed (R-NY), and Buddy Carter (R-GA) lead the bill.
  • View the current list of cosponsors – in the Senate and in the House.
NHPCO and the Hospice Action Network extend deep appreciation to the many professionals and hospice advocates that supported efforts to move this legislation forward.

Tuesday, June 19, 2018

It's Virtual Hill Week: Make Your Voice Heard!

Virtual Hill Week is June 18-22, 2018, and everyone across the U.S. is encouraged to participate: hospice staff, caregivers, family members, patients, supporters, and community members.

NHPCO and its affiliate organization, the Hospice Action Network, are asking citizens to urge Congress to support access to hospice care and quality end-of-life care for all Americans.

Please set aside a few minutes this week to ask Members of Congress to cosponsor the Rural Access to Hospice Act (PDF). The Rural Access to Hospice Act would help millions of rural Americans retain their attending physician when transitioning to hospice care. Please contact Congress today and make sure your voice is heard on Capitol Hill.

Hospice Action Network has created a Virtual Hill Week website and online advocacy module that makes it simple to ensure your elected officials know of your support for quality end-of-life care. The advocacy module offers a series of communication options, including submitting an email, making a phone call, and posting on social media. NHPCO and HAN urge you to consider completing all options!

Do your part this week to advocate on behalf of patients facing serious illness and the end of life. If you have any questions, feel free to email the HAN Team at

Friday, June 15, 2018

Opioid Bills Pass in the House

On June 13, 2018, lawmakers in the U.S. House of Representatives approved over two dozen bills that will help mitigate the impact of opioids, synthetic drugs, and other pain management medication on communities.

Important news for the U.S. hospice community is that the "Safe Disposal of Unused Medication Act" (H.R. 5041) was among the many bills approved, passing unanimously with a 398-0 vote.

Currently, the Drug Enforcement Administration forbids hospice personnel from destroying unused medication unless authorized by state law. This commonsense, bipartisan legislation will allow hospice personnel to assist in the disposal of unused medication following a patient’s death, helping decrease the opportunity for diversion, addiction and unintentional misuse of prescription drugs.

National Hospice and Palliative Care Organization strongly supported this important legislation and applauds the bill’s sponsors Congressman Tim Walberg (MI-07), Congresswoman Debbie Dingell (MI-02), and Congressman Richard Hudson (NC-08) for their leadership in fighting America’s opioid crisis.

It is the understanding of the NHPCO policy team that all the bills voted on June 13 will be merged into a single bill that will be sent to the Senate for its consideration. NHPCO hopes that the legislation will be signed into law in the coming months.

Additionally, CMS issued an Opioids Road Map outlining its efforts to address this issue of national concern. In this roadmap, CMS details a three-pronged approach to combating the opioid epidemic, focusing on:
  • Prevention of new cases of opioid use disorder (OUD)
  • Treatment of patients who have already become dependent on or addicted to opioids
  • Utilization of data from across the country to target prevention and treatment activities
Read the CMS Opioid Road Map blog post published June 11.

Monday, June 11, 2018

Father's Day and #MyHospice

It’s less than one week until Father’s Day, June 17. While the connection between Father’s Day and hospice might not seem the most obvious, this can be a time to help raise awareness. Father’s Day is all about honoring those individuals who have fulfilled a paternal role in our lives – whether it be our dad, grandfather, or other special person. Father’s Day provides a wonderful opportunity for the hospice and palliative care community to share and promote stories about the compassionate, coordinated care that we provide to dads, or those who are like a dad, and families who need our support at the end-of-life.

Raising awareness of the importance of hospice care and the value of the Medicare hospice benefit is what the new My Hospice Campaign is all about. Taking the opportunity Father’s Day affords to recognize the day with a story from our community reminds people that #MyHospice is about the compassion and dignity we bring to all those we serve.

NHPCO and HAN have created several #MyHospice assets, including social media and special messaging, for you to use to honor someone on Father’s Day.

Get involved: please visit our Father's Day webpage to learn more.


Additionally, don’t forget to share with My Hospice your stories about dad or others who fill a paternal role! 
Happy Father’s Day to all those who care so much!

Thursday, June 7, 2018

Catch the Early-Bird for 2018 Virtual Conference

Register by June 8 for early-bird registration rates for the 2018 Virtual Conference "Turning Points: Mastering Transitions in Care" hosted on July 18 - 19, 2018. Transitions can come in many different forms. Like a shift in care settings or a situation that requires the team to reframe and tap into new approaches or shift perspectives. This Virtual Conference will explore these important points.

Presented by three highly-regarded organizations, NHPCO, AAHPM and HPNA, the 2018 Virtual Conference is one of the most economical and convenient ways to bring high quality education to your team or your office without the expenses associated with a traditional "out of town" conference. The educational line-up for the 2018 Virtual Conference is available online - and online registration for this worthwhile event is open.

Plenary presentations that will be broadcast live from NHPCO:
  •  Opening Plenary - "Hospice: Intruder or Emissary? One Family's Experience" with Robin Romm
  • Plenary II - "De-Prescribeing: Facilitating a Key Transition Point for Patients and Families" with Mary Lynn McPherson, PharmD, MA, MDE, BCPS, CPE and Shaida Talebreza, MD, FAAHPM, HMDC, AGSF
  • Plenary III - A Picture is Worth a Thousand Words: Using Communication to Enhance Care Transitions" with Laura Shoemaker, DO, MS
  • Closing Plenary - "The Invisible Transitions Inside the Labyrinth of Caregiving" with Debbie Parker Oliver, PhD, MSW
Download the Agenda at a Glance (PDF) to see currently scheduled sessions presented over the two days of the conference.

Register online by June 8 to take advantage of early-bird registration rates!  (Of course, normal online registration rates are available after that date.) 


Friday, June 1, 2018

We Honor Veterans Releases New Video to Recruit Hospice Partners

In March of 2018, three NHPCO staff members – Katherine Kemp, Hope Fost, and I - embarked on a trip to Severn, Maryland to meet Albert Sherard, a 92-year-old Vietnam Veteran and Hospice of the Chesapeake patient. We interviewed Mr. Sherard, his daughter Winette, and members of the hospice staff to create a video that would give partners a tool to promote the work they are doing, help educate the public about We Honor Veterans and more importantly, recruit new hospice partners to the program. We gathered great material to work with but came away from this trip with much more. We all felt honored to spend time with an American hero and witness the beautiful connection that he and his Veteran-to-Veteran volunteer have made. To see the benefits of the We Honor Veterans program in person and in action is priceless!

In the video, viewers get a glimpse of how Albert and his Veteran-to-Veteran volunteer Charles DeBarber spend their time together. The Veteran to- Veteran volunteer initiative is a required activity once WHV partners reach Level Three. Hospice of the Chesapeake, a Level Four partner, has has a robust Veteran-to-Veteran volunteer program.

Pictured left to right are Veteran-toVeteran volunteer Charles DeBarber, Katherine Kemp, Amanda Bow, Albert Sherard, Winette Sherard, and Hope Fost.
 “Our We Honor Veterans program brings together our Veterans in the community to our Veteran patients,” said Hospice of the Chesapeake Director of Volunteer Services Mary Jermann. “And there’s a really powerful brotherhood and relationship there that is experienced through the multitude of the relationships that are formed here at Hospice of the Chesapeake.”

Albert was an avid gardener but with his declining condition, he is unable to be as active as he once was. Charles has found a way to bring the outside in. The video shows the two Veterans at Albert’s kitchen table preparing plants that will eventually make their way into the ground. The connection between the two is evident on screen and Albert’s daughter Winette reinforces the idea. “I think he feels good that it’s a Veteran he can talk to,” Winette said. “There is something that happens that makes it a brotherhood, even though they are very different ages.”

Additionally, the video highlights the goals of the WHV program and explains why it’s vital that hospice organizations become partners.

Hospice of the Chesapeake CEO & President Ben Marcantonio encourages other hospice programs to join WHV. “We became keenly aware of how many Veterans are served through our hospice population. Those people who need hospice care - of those people, 25% in our region are Veterans. So just that in and of itself was a compelling argument for our commitment to this aspect of our service.”

WHV partner programs are invited to use the video to educate their community about their partnership and for promotional opportunities.  Watch the video below; it can also be found on the WHV website and on YouTube

By Amanda Bow
Director of Communications

Monday, May 21, 2018

What Is the #MyHospice Story Bank?

If you don’t already know, My Hospice is a campaign to reinforce the value of the Medicare hospice benefit among policy and healthcare decision makers to foster a policy environment that will support patient access to high quality, comprehensive hospice and palliative care.

Whether you are a loved one of a person who received hospice care or a member of the hospice Interdisciplinary Team – and that includes dedicated volunteers – we believe that your story deserves to be shared and is essential to showcasing the purpose and value of hospice care. Write about your hospice experience and what hospice means to you, then submit it in the My Hospice Story Bank.  If selected, your story could be:
  • Shared in HAN and/or NHPCO social media messages using #MyHospice
  • Featured in HAN blog posts
  • Shared in NHPCO’s NewsLine or NewsBriefs
  • Featured in your local newspaper
  • Featured in an NHPCO video
If you’re interested in sharing your story, click here.  You can also learn more about the My Hospice Campaign.

Tuesday, May 15, 2018

A Unified Theory of Home-Based Care

You may not know this, but I am fascinated by quantum physics.  No, I don’t actually understand it, nor can I do the math involved, but I am like a curious two year-old when it comes to the idea that the laws governing small particles and large planets are actually the same.  It turns out that the visuals our science teachers taught us about electrons orbiting nuclei were not exactly right from a scientific perspective but a really helpful way to think about this.

So, as usual, what does any of this have to do with hospice or home-based care in general?  Well, we are consumed these days by large celestial bodies that are going to reshape health care.  Walmart, Amazon, Google, are all vying for a piece of the health care pie.  This is both tantalizing and a little scary.  But what if the laws that apply to these large bodies are the same as the laws that apply on the ground? Think about it. While Amazon completely disrupted the business model of traditional brick-and-mortar retailers, it created huge opportunity for smaller, nimbler organizations like delivery services and the specialty realtors who contract with Amazon for those more niche products. A similar evolution in health care could actually play to hospices’ strengths.

I think that when all of the hoopla dies down, and we deal with reality, we will see that this is exactly right.  You see, no matter how much buying or technology power an entity has, people still covet and receive health care (if done right) in a personal, local and convenient manner.  While we can bring the efficiencies and technology of large bodies to health care, and we should, we will not replace that crucial fact.  Even in the Jetsons, neither Rosie the Robot, nor the food eracacycle, delivered health care.

A unified theory of home-based care, just like a unified theory of physics, has been elusive.  Over the coming months, you’ll hear much more about my theory.  For today, suffice it to say that it will be person-centered, interdisciplinary, and will leverage the best of our past with the scale, technology and efficiency of the future.  We’ll be less chopped up by geography or tax status, or even Medicare benefit category.  A unified theory demands that we focus on the one core truth that helps inform all we do.  That part is easy.  It’s about people. No matter the scale, people need care from other people. 

By Edo Banach, JD
President and CEO

Tuesday, May 8, 2018

Happy Nurses’ Week!

It’s hard for me to believe I have been a nurse for over 30 years; however, in my heart, I have been a nurse much longer. Even as a little girl I knew I wanted to become a nurse.  I grew up in a time where there were strong role model nurses on TV shows which fueled my conviction.  

Nursing is an art and a science. The possibilities open to nurses are amazing! From the hospital, to the clinic, to the home, or the laboratory or the classroom, we make an impact on people’s lives every day. And in giving we get so much more back in return.

Like most new grads, my career started in the hospital. I worked on the medical surgical floors before gravitating to oncology which then merged with telemetry, offering me another skill set. Then, I moved to a relatively new bone marrow transplant unit which included adult and pediatric patients. After a move and a second child, I found a part-time job as an outpatient nurse for a drug and rehab center. Another important skill set was learned.  

When I moved out to the country, which I lovingly called the middle of nowhere, I thought my nursing career was over. Little did I know I was about to find my niche.

Responding to an ad for a hospice nurse at a satellite branch of a large community-based hospice opened my opportunities to the full scope of nursing practice. The hospice model, which is holistic, person-centered and interdisciplinary, blew my mind. I wondered why all health care wasn’t built on this model? When I called a primary care physician about their patient, they wanted to know what I recommended. Wow!  I quickly realized I needed to always be prepared and have current evidence to back up my recommendations. I also hoped the hospice model of care would move upstream in care delivery during my lifetime.  

As a nurse leader, I am engaged in that very work today.

In hospice nursing I also honed the art of listening. Listening first is so very important to giving high quality care. While I have built a wealth of skills throughout my career, from bedside nursing, operating complex devices, tackling electronic documentation optimization, developing operational budgets and new programs, managing and leading teams, the single most important skill I have learned is listening.

Great nurses listen with an open heart, to the individual, their family, their co-workers, and their community. These nurses see a person, not a patient.  Nurses dare to care with empathy, understanding this individual before them could be their loved one or themselves.  Great nurses don’t assume, they listen, and because they do, they learn more than any algorithm or protocol can provide. 

I am a nurse who believes in the value of technology. I look for ways to leverage technological advances in providing care to the seriously ill. But I also know that technology can never replace human caring. And human caring starts with active listening.

To all my fellow nurses, happy Nurses’ Week! Please continue to advance your skills and education because you make a difference in the lives of others every day. And never forget the great art of listening.

Lori Bishop, MHA, BSN, RN, CHPN
Vice President of Palliative & Advanced Care

Thursday, May 3, 2018

FY2019 Hospice Wage Index Proposed Rule

On Friday, April 27, 2018 CMS posted the FY2019 Hospice Wage Index Proposed Rule. Staff at NHPCO analyzed the proposed rule and published a Regulatory Alert on April 30, 2018 that provided more detailed information for the membership. Some highlights of the proposed rule include:
  • Hospice rates will increase by 1.8% for FY2019.  The cap amount has also increased by the same percentage to $29,205.44.  
  • Physician assistants will be able to serve as a hospice patient’s attending physician, effective January 1, 2019. NHPCO has worked in collaboration with the American Academy of Physician Assistants for their inclusion in the statute. Hospice patients will have additional choices for their attending physician once this provision is effective. 
  • CMS has reduced regulatory burden for hospice providers by allowing drugs and durable medical equipment to be reported in the aggregate on the claim form, rather than the extremely burdensome per drug or per equipment reporting that currently exists. CMS estimates that the elimination of this burdensome reporting will reduce the number of line items reported on claims by 21.5 million, in the aggregate.   
  • There will be no new hospice quality measures in FY2019. 
  • Data points from the hospice public information, currently available in the Provider Use File and posted by CMS, will be added to an “information” section in Hospice Compare, so that Medicare beneficiaries and their families have information that will assist them in selecting a hospice that meets their needs. 
CMS published a data trend analysis of hospice claims and cost report. Concerns continue to be raised about the number of patients who did not receive a skilled visit in the last seven days of life, the number of drugs paid for by Part D after the patient has elected hospice, and the lack of completeness in the hospice cost report. It's essential that hospice providers be aware that there is likely to be increased focus on these areas in the future.

Comments on the proposed rule are due to CMS no later than June 26, 2018. NHPCO submits a comment letter and encourages all providers with feedback to share that with CMS.

NHPCO members will find more detailed analysis in its Regulatory Alert (04/30/18).