Friday, December 19, 2014

New study shows benefits of home-based palliative care

Research published in the Journal of Palliative Medicine finds that home-based palliative care programs may achieve cost savings while helping provide care across the continuum.

Researchers led by Christopher W. Kerr, MD, PhD, examined the impact of a home-based palliative care program that was offered through a partnership between a hospice and a private nonprofit commercial insurance payer in western New York state
The findings are reported in an article, "Cost Savings and Enhanced Hospice Enrollment with a Home-Based Palliative Care Program Implemented as a Hospice–Private Payer Partnership," published in the new edition of the Journal of Palliative Medicine (Volume 17, Number 12, 2014).

The most significant savings were found in the final three months of life where cost savings for those who utilized the available home-based palliative care services was $6,804 per member per month. Hospital admissions and specialty visits were significantly lower than in the control group. Additionally, researchers found that hospice access was enhanced (70% versus 25%) and longer length of stay in hospice were observed.

Researchers wrote, "Collectively, these findings demonstrate the significant potential of a home-based palliative care program to achieve the Institute of Healthcare Improvement's Triple Aims goals of lower costs, higher quality, and improved satisfaction."

Access the article abstract online - a link to the full article is available.

Monday, November 3, 2014

"Take a Moment. Make a Moment." on November 7

In honor of National Hospice & Palliative Care Month 2014, NHPCO will be encouraging member organizations, hospice professionals, and the general public to participate in a nationwide social media push entitled: “Take a Moment. Make a Moment.” on Friday, November 7, 2014.

Why you should participate in “Take a Moment. Make a Moment.”
Social media is more prevalent than ever and NHPCO wants to help member organizations experience the benefits by getting involved online. "Take a Moment. Make a Moment." is designed so that hospice providers of any size can participate.

On Friday, November 7,  NHPCO and all participating organizations/professionals will post photos of special moments made possible by hospice and palliative care. By using compelling photographs and uniform messaging, the hospice community will be able to draw attention to National Hospice & Palliative Care Month and the hospice community as a whole.

Benefits of Participating
NHPCO is offering some wonderful incentives for member organizations to participate on November 7.  Organizations who contribute to “Take a Moment. Make a Moment.” will receive:

•  An online “Moments of Life” Participant Badge. Participating organizations will be given access to an online icon that can be used on your website to signify your involvement in this national campaign.

•   A unique web page on The Moments of Life: Made Possible by Hospice website is viewed by thousands of individuals each month. Organizations who participate in “Take a Moment. Make a Moment.” will be given a unique web page in the Share Your Story Photo Gallery Section of the website. On this unique web page, NHPCO will include a hyperlink to your organization which will enhance web presence. In addition, organizations can use their unique webpage as an effective online promotional tool.
We hope that you will join NHPCO on Friday, November 7 for “Take a Moment. Make a Moment.” By participating, you will be helping to spread awareness about hospice & palliative care and will also receive online assets that will demonstrate your organization’s involvement with hospice & palliative care on a national level.

To learn how to participate, visit the official “Take a Moment. Make a Moment." webpage.

Tuesday, October 28, 2014

Hospice Volunteers Honored for Outstanding Service

The National Hospice and Palliative Care Organization recognized four outstanding volunteers at the organization’s 15th Clinical Team Conference held in Nashville, Tennessee.  The Volunteers are the Foundation of Hospice Awards recognizes hospice volunteers who best reflect the universal concept of volunteerism in its truest sense—serving as an inspiration to others.

This year’s recipients and the area for which they were honored are:

Clarence Smith, a volunteer with Beacon Hospice, an Amedisys company, in South Portland, Maine, for patient and family support.  He is a Korean War veteran who is actively involved in Beacon’s We Honor Veterans program, has volunteered since 2007 and has logged approximately 1,200 hours in patient visits.

Elizabeth “Betty” Takes, a volunteer with Hospice of Dubuque in Dubuque, Iowa, for organizational support. She has dedicated over 30 years of her life to Hospice of Dubuque both professionally as a nurse and personally as a volunteer and board of directors member.

Margi Miller, a volunteer with Tidewell Hospice in Lakewood Ranch, Florida, for specialized volunteer support.  She uses her musical and artistic talent to help patients and families and has provided over 1,000 hours of service.

Katharine Foster, a volunteer with BJC Hospice in St. Louis, Missouri, for young leader support.  She is a pre-med student who began volunteering in 2012.  Since then she has logged 200 hours of direct patient contact. 

Volunteers play an integral role in hospice care and each and every one deserves recognition and the highest accolades.  From direct patient support and caregiver relief to administrative support in a local hospice office, hospice volunteers selflessly give of their time to serve patients and families who are facing end-of-life challenges,” said J. Donald Schumacher, NHPCO president and CEO. 

NHPCO reports that there are more than 355,000 trained hospice volunteers contributing more than 16 million hours of service to hospice organizations across the country.

Volunteer Award recipients (L to R): Katharine Foster, Betty Takes, Margi Miller, and Clarence Smith.

Friday, October 17, 2014

NIH Grants for Research on Arts in Palliative Care

The National Institutes of Health has funding opportunities to support arts-based approaches in palliative care for symptom management. NIH has posted information about a Research Project Grant, "Arts-Based Approaches in Palliative Care for Symptom Management" (R01).

As stated in the NIH announcment: The purpose of this funding opportunity announcement (FOA) is to support mechanistic clinical studies aimed at understanding the impact of arts-based approaches in palliative care for symptom management. This FOA is intended to support mechanistic clinical studies to provide an evidence base for the use of the arts in palliative care for symptom management. The objective is to understand the biological, physiological, neurological, psychological, and/or sociological mechanisms by which the arts exert their effects on symptom management during and throughout the palliative care continuum. The goal is for the research supported under this FOA to develop an evidence-base that could be used as a basis for the uptake of arts-based therapies in palliative care settings, among individuals across the lifespan, with a wide variety of serious chronic conditions and their accompanying symptoms. This FOA is not intended to determine efficacy or the comparative effectiveness of interventions, or to assess interventions designed to treat the underlying cause of a particular disease state.

The Funding Opportunity Announcement (FOA) Number is PAR-14-294.

Find more information at:

Tuesday, October 7, 2014

President Obama Signs IMPACT Act Bringing Valuable Oversight to Hospices

Yesterday afternoon, President Obama signed into law the “Improving Medicare Post-Acute Care Transformation Act of 2014” (IMPACT Act) that includes provisions creating greater oversight and increased transparency within the hospice community. The National Hospice and Palliative Care Organization heralds the passage of this legislation and the additional oversight it will bring to end-of-life care providers.

The provisions that affect hospice providers are:
  1. Mandated surveys of Medicare certified hospice providers at least every three years for the next ten years at the minimum.
  2. Medical reviews for hospice programs with a soon to be determined percentage/number of patients receiving care for more than 180 days. The specific patient load that would trigger this medical review will be set by CMS.
  3. Hospice aggregate financial cap will be aligned with hospice reimbursement using a common inflationary index that will not change hospice reimbursement for providers.
“As hospice and palliative care providers, we care for patients and families at one of life’s most vulnerable times.  Americans need to know that all Medicare-certified providers are committed to the highest standards of quality and compliance.  This new law strengthens oversight and transparency throughout the entire hospice community,” said J. Donald Schumacher, NHPCO president and CEO. “NHPCO applauds President Obama for signing the IMPACT Act into law.”

“Under NHPCO’s leadership, the hospice community has been on the frontlines of advocating for increased transparency, program integrity, and accountability. We believe that the hospice provisions included in the IMPACT Act are critically important steps in this direction,” stressed Schumacher.

Thursday, October 2, 2014

CMS Invalid Hospice Diagnosis Codes

Hospice providers should be aware of the list of “Invalid Hospice Diagnosis Codes” which should not be used as a primary diagnosis for a hospice patient for dates of service beginning October 1, 2014 or later.

The Centers for Medicare and Medicaid Services issued CR 8877, "Hospice Manual Update for Diagnosis Reporting and Filing Hospice Notice of Election (NOE) and Termination or Revocation of Election" on August 22, 2014.  At that time NHPCO advised the field and created a compliance update document in late August with the details of all provisions of CR 8877.

Recently, the Regulatory Team at NHPCO has received numerous questions about the invalid diagnosis codes contained in Attachment A of this CMS Change Request.  Of particular importance are coding guidelines related to:
  • ICD-9-CM/ICD-10-CM Coding Guidelines
  • ICD-9-CM/ICD-10-CM Dementia Coding Guidelines
  • Hospice Invalid Principal Diagnosis Codes 
Providers should be familiar with the provisions of CR 8877, "Hospice Manual Update for Diagnosis Reporting and Filing Hospice Notice of Election (NOE) and Termination or Revocation of Election." This Change Request provides a manual update and provider education for CMS edits in place for principal diagnoses that are not appropriate for reporting on hospice claims.

NHPCO members looking for assistance with CR 8877 will find a Regulatory Alert (10/02/14) posted on the NHPCO website that includes a link to the original compliance update document released last August.

Thursday, September 25, 2014

Naomi Judd to open national hospice palliative care conference in October

Naomi Judd will be the honored opening plenary speaker at NHPCO’s upcoming Clinical Team Conference in Nashville, Tennessee, October 27 – 29, 2014.

At the opening plenary presentation on October 27, the celebrated Naomi Judd will present, “Surviving and Thriving in Challenging Times” at the opening session of the National Hospice and Palliative Care Organizations 15th annual Clinical Team Conference and Pediatric Intensive being held at the Gaylord Opryland Resort & Convention Center.

Naomi Judd knows a thing or two about surviving and thriving through challenges. Using her own touching personal stories and unique brand of humor, Naomi will share her journey of being both a patient (as a Hepatitis C survivor) and a caregiver (as a former nurse early in her life).

From humble beginnings as a single mom in a small Kentucky town to her meteoric rise as a country music superstar and American icon, Naomi Judd’s incredible lifelong journey is an inspiring story of overcoming the odds through optimism and hard work, first known to the world as half of country music’s mother/daughter duo, The Judds. Reaching unprecedented success throughout the 80’s and 90’s, The Judds sold 20 million records, scored fifteen #1 hits and received over sixty industry awards including six Grammy’s, seven consecutive CMS Vocal Group of the Year awards and ACM’s Top Vocal Duet award.
As the pinnacle of their career, Naomi was stricken with Hepatitis C, a potentially fatal chronic liver disease, incurred from an infected needle when she worked as a registered nurse, cutting short her musical career and forcing her into retirement to battle the disease.

Today, Naomi is a survivor of Hepatitis C and uses her fame, her experience as a former RN and her passion to reach and help people in a variety of mediums including public speaking, film, television and radio shows, including her six-week SiriusXM radio series, “Think Twice” which aired the summer of 2012, and authoring seven books which include two New York Times best-sellers. Meanwhile, Naomi also continues her humanitarian efforts.

On-site conference registration is available for single day passes, the full conference, and preconference seminars (October 25 – 26). Visit the CTC registration desk at the Gaylord Opryland Convention Center. For more information on the CTC and educational offerings, see the Clinical Team Conference information online.

(Online registration  with a reduced registration fee is available through October 2, 2014.)

Friday, September 19, 2014

NHPCO Applauds Passage of the IMPACT Act

Hospice provisions added to the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) will create increased transparency within the hospice community.

This week, the U.S. House of Representatives and Senate passed the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), legislation which includes hospice integrity provisions that are backed by the hospice community.  The National Hospice and Palliative Care Organization ( supports this legislation and the additional oversight it will bring to end-of-life care providers.

The IMPACT Act (H.R. 4994) requires more frequent surveys of hospice providers – a measure the hospice community NHPCO has championed for more than a decade. The bill mandates that all Medicare certified hospices be surveyed every three years for at least the next ten years.
A 2007 HHS Office of the Inspector General report found that current survey measures for Medicare-certified hospices was not providing sufficient oversight.

“Currently, hospices can go eight years or more without ever being surveyed, which is far too long,” said J. Donald Schumacher, NHPCO president and CEO. “More consistent surveys, and the process providers go through to prepare for them, will help hospices and ultimately benefit the patients and families in their care.”

Additionally, the new legislation will facilitate medical reviews for select hospice programs with a soon to be determined percentage/number of patients receiving care for more than 180 days. The specific patient load that would trigger this medical review is yet to be set by CMS.
Such a medical review of what are known as “long stay” patients will help ensure that hospices are appropriately caring for individuals with life-limiting illnesses that are often harder to prognosticate than in the earlier days of hospice provision when most patients had a cancer diagnoses.

NHPCO has supported this provision since it was originally recommended by MedPAC in 2009.

The legislation also includes a provision that would align hospice reimbursement and the hospice aggregate financial cap to a common inflationary index.

“Under NHPCO’s leadership, the hospice community has been on the frontlines of advocating for increased transparency, program integrity, and accountability. We believe that the hospice provisions included in the IMPACT Act are critically important steps in this direction,” stressed Schumacher.

NHPCO reports that more than 1.5 million dying Americans receive care for the nation’s hospice providers every year.

Wednesday, August 27, 2014

Children with Medical Complexities: Free e-journal

A new edition of the free e-journal published by NHPCO's Children's Project on Palliative/Hospice Services is available online. Children with Medical Complexities, Part One (Issue #36; August 2014) is a free e-journal published by NHPCO’s Children’s Project on Palliative/Hospice Services. This new edition is a collection of articles focused on caring for children with medical complexities. This is the first of two editions looking at this important topic.

As noted in the introduction of one of the articles, “Medically complex and fragile children with progressive diseases present unique and complex challenges for their medical management that require coordination, flexibility, and consistent community…between the family, hospice and medical teams.”

Alison Kirkland, a mother who wrote the article “After the Unexpected Happens,” shares her personal insight: “Despite the heartache and stress, parenting a child with medical complexities can be one of the most joyful and rewarding experiences of your life.”

Additional articles in this issue include:
•    Caring in Uncertainty: Children and Families with Genetic Conditions
•    The Partnership between Palliative Medicine and Children with Medical Complexity
•    Complex Care Coordination
•    Pediatric Palliative Care and Pediatric Surgery: Common Issues
•    Staff Bereavement in Palliative Pediatric Care

Visit the archive page of the ChiPPS e-journal/e-newsletter page on the NHPCO website for access to previous editions of this publication.

Tuesday, August 5, 2014

New Legislation Introduced to Promote Appropriate Hospice Oversight

Legislation requiring more timely surveys of Medicare-certified hospice care programs was introduced on Friday, August 1, before the House of Representatives adjourned for the August recess.  Led by Congressmen Tom Reed (R-NY) and Mike Thompson (D-CA), the Hospice Opportunities for Supporting Patients with Integrity and Care Evaluations (HOSPICE) Act, HR 5393, is being well-received by the hospice community.

The National Hospice and Palliative Care Organization enthusiastically supports this new legislation and applauds the work of Congressmen Reed and Thompson who are strong champions of hospice care.
The HOSPICE Act would require that hospices be surveyed no less frequently than every three years and authorizes funding for CMS to contract for the additional oversight.

The Office of the Inspector General (OIG) examined hospice survey frequency in 2007 and 2013 and found that the existing intervals and resources were inadequate.  The mandatory survey frequency in HR 5393 is consistent with the OIG recommendations.

Additionally, the new bill will make a technical correction to allow for implementation of existing law requiring CMS to conduct a medical review of hospice programs that reach to be determined threshold of patients under care for more than 180 days.  The threshold would be established by CMS.  NHPCO has supported this provision since it was originally recommended by MedPAC in 2009. 
“These are two important program integrity provision that have long-been supported by NHPCO.  The hospice community is very serious about compliance and protecting the quality of care that is promised by the Medicare Hospice Benefit,” said J. Donald Schumacher, NHPCO president and CEO.

This new bill builds on a provision from the HELP Hospice Act (HR 2302/S 1053) that addresses mandating hospice surveys as a critically important program integrity piece.

Friday, August 1, 2014

2014 Circle of Life Award® Presented

National Hospice and Palliative Care Organization and the National Hospice Foundation honor the recipients of the 2014 Circle of Life Award®.  Presented on July 21 at the American Hospital Association’s annual summit held in San Diego, the award celebrates innovation in end-of-life care and highlights programs that demonstrate superior vision, depth, and scope. 

The 2014 Circle of Life Award honorees are:
  • Baylor Health Care System Supportive and Palliative Care Services, Dallas, Texas
  • Lehigh Valley Health Network, Allentown, Pennsylvania
  • Yakima Valley Memorial Hospital and Foundation, Yakima, Washington
In announcing the honored recipients, AHA emphasized that the programs share overriding themes of creating and championing the role of palliative care through the community.

In addition to the three award winners, AHA presented a Citation of Honor to the Center for Palliative and Supportive Care, Ambulatory Program, University of Alabama at Birmingham.

“These programs serve as models for us all as we move forward in our shared goal of providing the highest quality of care for all those we serve,” said J. Donald Schumacher, NHPCO and NHF president and CEO. “We are proud to celebrate those care providers that are leading the way in innovation and quality care delivery.”

Since 2000, the Circle of Life Award has honored programs that demonstrate excellence and innovation in palliative and end-of-life care. Further information about the honorees and the Circle of Life Award is available at the AHA website.

The National Hospice and Palliative Care Organization and the National Hospice Foundation are major sponsors of the 2014 award, as is the American Hospital Association and the Catholic Health Association of the United States.

Left to right: Dr. Jonathan Perlin, American Hospital Association Board; Dr. Elizabeth Kvale, University of Alabama Birmingham; Diane Patterson, Yakima Valley Memorial Hospital; Donna Stevens, Lehigh Valley Health Network; Dr. Robert L. Fine, Baylor Health Care System; Mary Starmann-Harrison, AHA’s Executive Committee.

Friday, July 18, 2014

New CMS Guidance Issued on Part D and Hospice

Since March, the National Hospice and Palliative Care Organization has been working with the hospice community and many Congressional champions to halt implementation of a Medicare Part D policy that resulted in dying patients unable to get necessary medications under their Part D benefit. These efforts have been successful.

Today, the Centers for Medicare and Medicaid Services issued revised, interim guidance for hospice providers and Part D sponsors pertaining to Medicare beneficiaries who are receiving hospice care and are also enrolled in Part D.  The intention of the Medicare Part D policy is to prevent the federal government from paying for medications under Part D that are related to the terminal illness and should be the responsibility of the hospice.

This new Part D guidance substantially modifies guidance first issued on March 10, 2014 which generated confusion and concern for hospice providers and Part D sponsors, and most importantly, prevented hospice patients from accessing needed drugs.

An NHPCO survey of hospice professionals found the policy often left Medicare beneficiaries without needed medications unrelated to the terminal illness once they had elected their Medicare hospice benefit. Other dying patients either revoked or refused the hospice benefit, foregoing this compassionate care, in order to maintain access to medications unrelated to their terminal prognosis.
Since the March implementation, dying hospice patients and their family caregivers found themselves caught in the middle of the policy which many in the hospice community called well-intentioned yet misguided.

The revised guidance instructs Part D sponsors to use prior authorization only on four categories of drugs that are generally used to treat symptoms of pain, nausea, constipation and anxiety commonly seen in hospice patients. Prior authorization requirements on other categories of drugs will no longer be required from Part D sponsors.

The modified guidance was issued after months of intense discussion with CMS, Congress, and other stakeholders on the problems with the March guidance and a request from NHPCO to temporarily suspend the guidance until the issues could be resolved.
“We are pleased that CMS has taken this step to revise the March 10 guidance in keeping with the 2012 OIG report.  It will reduce the confusion for hospice providers and will allow patients to get their medications when they need them,” said J. Donald Schumacher, NHPCO president and CEO.
“As frontline caregivers, the hospice community led the effort to educate Congress and engage with stakeholders to halt the policy.  With this change, patients and their families will no longer be caught in the middle of troublesome policy and stakeholders can implement an interim solution that can more easily be understood by all providers,” Schumacher added.

NHPCO does not dispute hospices’ responsibility in paying for all medications and care related to patient’s terminal prognosis and will continue working to educate the hospice community on better navigating this intersection. 
CMS and all stakeholders will continue working to identify a more permanent solution to this Part D and hospice intersection.  Added Schumacher, “We remain committed to working collaboratively with all stakeholders to ensure that hospice patients receive the medications they need for comfort and quality of life and do not have to experience confusion and delay as they are facing the end of life.”

Tuesday, July 1, 2014

Focused Advocacy and Congressional Sign-on Letters Further Highlight Part D Issue

July marks the entry into the third month of implementation of the damaging policy involving Medicare Part D and hospice patient medications.  In response, the National Hospice and Palliative Care Organization reports a surge in advocacy activity to halt the negative consequences on dying Medicare beneficiaries
The poorly conceived policy issued by the Centers for Medicare and Medicaid Services, with a May 1, 2014 implementation date, was designed to prevent duplicate payments on medications for hospice patients. The unintended result of this policy is causing many dying Americans to forgo necessary medications that should be covered under Medicare Part D.
Through the efforts of Hospice Advocates across the nation, both Congress and CMS have heard what this misguided policy is doing to the patients and families being cared for by hospice providers.
“Coordinated advocacy efforts have brought some positive results but not a halt to the implementation of this policy,” said J. Donald Schumacher, NHPCO president and CEO. “Yet, even one patient at the end of life who suffers needlessly from this policy is one too many. It’s heartbreaking that CMS has failed to recognize the urgency of protecting these vulnerable patients.”
Congressional sign-on letters circulated by Senators Rockefeller and Roberts (PDF) and Representatives Reed and Thompson (PDF) emphasized the call for CMS to act.
The letters were signed by 75 Senators and 202 Members of the House of Representatives. Nineteen out of 24 Members of the Senate Finance Committee, which has jurisdiction over hospice in the Senate, and 26 out of 39 Members of the House Ways & Means Committee, which has jurisdiction over hospice in the House of Representatives, signed on to these letters.
Additional measures calling on CMS to stop implementation of the Part D policy include:
Additionally, last week, even the Medicare Payment Advisory Commission (MedPAC) commented on the guidance, and suggested that the guidance be suspended until a streamlined process, that does not impact the Medicare beneficiary, can be implemented.
For more information on this issue, please visit the Hospice Action Network’s Hospice & Part D webpage at

Tuesday, June 17, 2014

Call to Action: Contact your legislators to support hospice care!

Today, you can make a tangible difference for hospices across the nation. Hospice Action Network and the National Hospice and Palliative Care Organization are encouraging all hospice supporters to call their Members of Congress and voice their concern about the Hospice & Medicare Part D issue.

On June 17, over 240 of your fellow Hospice Advocates, representing 47 states and districts, and every discipline in the IDT, are in Washington, DC, visiting more than 300 Congressional offices to call for support of hospice.

Advocates on Capitol Hill will request that Congress ask CMS to temporarily suspend the Part D implementation for hospices- and Americans across the national are needed to convey this same message from their homes.  

The Hospice Action Network has created an easy to use online "Click to Call" Campaign that will help people understand the issue and then connect them to their Congressional representatives. The whole process should take no longer than 30 minutes, start to finish- that’s all it takes for you to make a difference.

To watch our video, which explains the Part D policy changes, and how the calling system works to connect you to your Members of Congress, visit this special page of the Hospice Action Network website.


Monday, June 9, 2014

CMS Part D policy hurting hospice patients and families

A hospice patient in Oklahoma City is being denied his medications to treat his COPD, while coping with a diagnosis and treatment for tongue cancer.  In Cadillac, Michigan a patient struggling with colon cancer is being denied insulin to treat his diabetes and is in danger of diabetic shock.

Due to a recent and poorly thought out Medicare Part D Prescription Drug policy, dying patients are revoking hospice services to maintain access to other necessary prescriptions for diseases unrelated to their terminal illness that Part D have paid for until recently. 

Patients’ families are left at the pharmacy counter with no refill of medications, after the pharmacist announces that because the patient is on hospice, the pharmacy is no longer allowed to fill their prescriptions – which in not accurate.  Or they are going days, sometimes weeks, without the necessary medication to manage symptoms that were present before they elected the hospice benefit due to unnecessary complications in approving prescriptions under Part D.

The intention of the new Medicare Part D policy implemented by the Centers for Medicare and Medicaid Services is to prevent the federal government from incurring duplicate costs for medications of hospice patients. 

The National Hospice and Palliative Care Organization has strongly opposed the inadequate and haphazard implementation of this guidance. 

NHPCO agrees that hospice providers should be held responsible for all drugs that are related to the terminal diagnoses and those drugs that are unrelated should be billed to Medicare Part D.  

NHPCO acknowledges that there have been instances of Part D payment for drugs that should have been covered by the hospice provider under the Medicare hospice benefit. 

NHPCO continues to encourage CMS to halt the implementation of the Part D guidance and convene key stakeholder groups to collaborate and create a strategic and uniform process.  An effective solution can be reached so that Part D providers, pharmacists, hospice providers and beneficiaries have developed a coherent process together and hospice patients are not denied the medications they need at the end of life.    

Monday, June 2, 2014

NHPCO and NHF Mourn the Death of Chair Emeritus Zachary Morfogen

With much sadness the National Hospice and Palliative Care Organization and the National Hospice Foundation share the news of the death of Zachary Paul Morfogen, of Palm Beach who died Tuesday, May 27, 2014. He was 85 and was with family in Pennsylvania at the time of his death.

As founding chairman emeritus of what was the National Hospice Organization and the National Hospice Foundation, Mr. Morfogen was a longtime advocate for hospice and currently served on the Foundation’s Board of Governors.

He became one of the nation’s earliest advocates for hospice care during his tenure as a trustee of Riverside Hospital in New Jersey.  While there, Mr. Morfogen persuaded Riverside Hospital to establish one of the nation’s first free-standing hospices and later convinced Time magazine to do a story about the then growing hospice movement in the U.S.

During the early years of his work with Riverside Hospital, Mr. Morfogen saw firsthand the need for more compassionate care for the dying. At the suggestion of a colleague, he visited Cicely Saunders, founder of St. Christopher’s Hospice in London and widely recognized as the founder of the modern day hospice model. About his visit at St. Christopher’s he shared:

One day there, I saw a hospice patient who had to be in her eighties celebrating her birthday – big party, cake, candles, the whole bit. I said to Cicely, “So, how long does she have left?” Cicely said, “Oh, about a week.” I thought, wow, what a difference between what this was and what I saw at Riverside.

He was dedicated to the arts and was actively involved in the creation of the ground-breaking exhibition, “Hospice: A Photographic Inquiry,” that opened at the Corcoran Gallery of Art in Washington, DC in 1996 and then toured the nation.

A love for the power of art to communicate and educate led to the creation of the National Hospice Foundation’s Zachary Morfogen Art of Caring Award which recognizes those who use the arts to increase awareness of hospice care.

Mr. Morfogen was a painter and author whose books included You Gotta’ Have Art and Dealing with Death Free From Fear which was published only this month.

He is survived by his two children and their spouses, seven grandchildren, two great-grandchildren, and a sister. His beloved wife, Marilyn, died in 2011.

Memorial contributions may be made in his memory to the National Hospice Foundation, 1731 King St., Alexandria, VA 22314 or The Roosevelt Institute, New York, NY.

Mr. Morfogen’s obituary and online condolence book are available online.

Friday, May 30, 2014

Ground-breaking Palliative Care Resolution Adopted at World Health Assembly in Geneva

Signals progress to end unnecessary pain and suffering due to lack of quality care
The National Hospice and Palliative Care Organization joins other palliative care advocates across the globe in celebrating the resolution on palliative care adopted at the World Health Assembly on May 23, 2014 in Geneva, Switzerland.

The adoption of this first-ever resolution calling for the integration of hospice and palliative care  into national health services reflects growing awareness of the unaddressed care needs for the millions of people worldwide with  life-limiting conditions such as cancer, heart disease, HIV, and multi-drug resistant TB.

The resolution outlines clear recommendations to improve access and availability of hospice and palliative care. These include ensuring palliative care is included in all national health policies and budgets, and in the curricula for health professionals.  Iit also highlights the critical need for countries to ensure that there is an adequate supply of all essential palliative care medicines for appropriate pain control for adults and children.

The Sixty-seventh session of the World Health Assembly  took place in Geneva May, 19 – 24, 2014. The WHA is the supreme decision-making body of World Health Organization.

Read the full NHPCO press release (05/28/14).

Friday, May 16, 2014

NHPCO Launches New Moments of Life Campaign

Patients’ and families’ stories show hospice is about more than death – it’s about life

In celebrating the 40th anniversary of hospice care in the United States, NHPCO is excited to introduce a new national campaign, “Moments of Life: Made Possible by Hospice,” that will show all Americans that hospice focuses on living and enables special moments and memories at the end of a life for patients and loved ones.

A father’s final wedding dance with his daughter; a Veteran’s visit to the WWII Memorial; the opportunity to bring an infant daughter home; an afternoon tea party with grandchildren… these are only some of the moments made possible by hospice.

The Moments of Life awareness campaign will feature stories gathered by hospices across the country of patients and families experiencing hospice care first hand. The stories will take the form of videos, photos, audio recordings and text and will offer a vibrant cross-section of different perspectives of hospice.

“In this campaign, we are looking for real stories that show patients’ abilities to ‘do more’ as a result of their experience on hospice,” said Anita Brikman, senior vice president of communications for NHPCO. “No matter what format is used, these stories should show America that even when you’re dying, there is still a lot of living to do.”

For many who have not seen hospice in action, it has become a common misconception that hospice patients are merely lying in bed, waiting for their end to come. For families who have experienced hospice, they see the focus is not on dying—it is about living as fully as possible.  Hospice not only provides the highest quality care, it affords more moments, memories and opportunities.  

For more information visit the new Moments of Life microsite at

Monday, April 14, 2014

Join National Healthcare Decisions Day…Because Your Decisions Matter!

April 16, 2014, will be the seventh annual National Healthcare Decisions Day.  The annual event, has been formally recognized by Congress and numerous state and local governments, and has included participation by 76 of the most prominent national healthcare, religious, and legal associations and organizations. 
At every level, the goal of this nationwide initiative is to ensure that all adults with decision-making capacity in America have both the information and the opportunity to communicate and document their future healthcare decisions.  The first years’ results were impressive—over 750,000 people obtained resources to make their healthcare decisions known—but there remain millions of Americans to go. 

While making healthcare decisions is often difficult in the best of circumstances, making decisions for others is even more complicated. Each of us has the ability to guide our healthcare providers and our loved ones about what we want. Advance directives give you the ability to document the types of healthcare you do and do not want, and to name an “agent” to speak for you if you cannot speak for yourself. Having an advance directive can be valuable for all adults, regardless of current age or health status.

In recognition of this, National Healthcare Decisions Day strives to provide much-needed information to the public, reduce the number of tragedies that occur when a person’s wishes are unknown, and improve the ability of healthcare facilities and providers to offer informed and thoughtful guidance about advance healthcare planning to their patients.

Please visit the National Healthcare Decisions Day website at for a variety of free materials (including free advance directives forms for every state) and tools to assist with thoughtful reflection on healthcare choices and ideas on how to get involved. Additionally, please share this information with your loved ones and colleagues.
With healthcare, “your decisions matter,” however, others need to know your wishes to honor them. There are no wrong answers when thinking about healthcare choices and completing an advance directive. Please use April 16, 2014, to decide, discuss, and document your wishes, whatever they may be.

Monday, April 7, 2014

Hospice Community Honors Its Volunteers during National Volunteer Week, April 6 - 12

National Hospice and Palliative Care Organization salutes the 400,000 trained hospice volunteers who serve every year.

Forty years ago, President Richard Nixon declared the first National Volunteer Week to recognize Americans who give of their time and talents to benefit others. This was the same year, 1974, that the Connecticut Hospice – one of the first hospices in the country – opened its doors changing the way dying persons were cared for in the U.S.

During National Volunteer Week, April 6 – 12, the National Hospice and Palliative Care Organization celebrates the work of all the dedicated hospice volunteers who provide support, companionship and dignity to patients and families being served by hospice.

More than 400,000 trained volunteers provide 19 million hours every year to help care for patients and families and to support hospice programs in their mission to serve.

Hospice volunteers are often at the bedside of patients and families but they also assist in the office, help raise awareness, contribute to educational programs, support bereavement programs, provide fundraising support, and more.

The National Hospice and Palliative Care Organization reports that every year, an estimated 1.6 million patients and their family caregivers receive the high-quality, compassionate care that hospice provides.

“Hospice volunteers help the people they serve live every moment of life to the fullest and enable the organizations they work with to achieve their mission in the community,” said J. Donald Schumacher, NHPCO president and CEO. “Most hospice volunteers choose to give their time helping others because of their own experience with the compassionate care hospice provided to a dying loved one.”

The overwhelming majority of hospice care is provided in the home and hospice volunteers are important members of the interdisciplinary team that make this happen.

It is federally mandated under Medicare that five percent of all patient care hours be provided by trained volunteers reflecting the vital role that volunteers play in the provision of care.
Thank you to every dedicated hospice volunteer serving in communities across the county.

Tuesday, February 18, 2014

2014 CTC Call for Proposals Deadline Has Been Extended!

Consider being part of the faculty at NHPCO's 2014 Clinical Team Conference.  There's still time to submit a proposal. Given that the last two weeks have been fraught with an abundance of weather issues, NHPCO has extended the CTC call for proposals deadline to February 24th at midnight (ET). 

Share your expertise with other hospice and palliative care professionals, learn from experts in the field, and enjoy the camaraderie of colleagues from around the country while visiting the beautiful Gaylord Resort and Convention Center in Nashville, TN.  Be sure that your organization is represented at the premier conference in our field. To submit a proposal for the 2014 Clinical Team Conference and Pediatric Intensive, visit the online submission page

Monday, February 10, 2014

2nd National Policy Symposium to look at length of service issues

NHPCO’s Hospice Action Network will host its second annual policy symposium, The Right Care and the Right Time:  An Open Conversation on Hospice Length of Stay, on March 25, 2014 in Washington, DC, to explore issues related to appropriate access for patients considering hospice care.
“While much policy attention has been dedicated to the 10 percent of patients who receive care under the Medicare Hospice Benefit for more than 180 days, there has not been nearly enough attention paid to more than 60 percent that die within 30 days,” said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization.
Regulators and organizations such as MedPAC have voiced concerns about long length of service (more than 180 days) that some hospice patients receive. In recent months, some media sources have focused on this segment of the hospice patient population, often misunderstanding the value hospice provides patients and family caregivers beyond what is known as “brink of death” care.
Many people incorrectly associate the prognosis requirement of six months or less that is necessary for a patient to access care under the Medicare hospice benefit as a limit to the amount of time a patient can receive care.  As long as the patient continues to meet the prognosis of six months or less – meaning the physician might expect the patient to die within six weeks if his or her medical condition continues to advance – the patient is eligible for hospice care.
In order to create a public dialogue and bring transparency to this complicated set of issues, the National Hospice and Palliative Care Organization’s HospiceAction Network (NHPCO HAN) is hosting The Right Care and the Right Time:  An Open Conversation on Hospice Length of Stay.
The second annual policy symposium hosted by NHPCO HAN is set for Tuesday, March 25, 2014, from 9:00 AM – 12:00 PM at Union Station’s Columbus Room in Washington, DC.  For event details and registration information, visit
HAN's 2013 Policy Symposium featured opening remarks
from Joe Klein of TIME Magazine.

Tuesday, January 28, 2014

First Ever Global Atlas Identifies Unmet Need for Palliative Care

Only 1 in 10 people who need palliative care - that is medical care to relieve the pain, symptoms and stress of serious illness - is currently receiving it. This unmet need is mapped for the first time in the Global Atlas of Palliative Care at the End of Life, published jointly by the World Health Organization (WHO) and the Worldwide Palliative Care Alliance (WPCA).
Palliative care is more than just pain relief. It includes addressing the physical, psychosocial and emotional suffering of patients with serious advanced illnesses and supporting family members providing care to a loved one.
About one third of those needing palliative care suffer from cancer. Others have progressive illnesses affecting their heart, lung, liver, kidney, brain, or chronic, life-threatening diseases including HIV and drug-resistant tuberculosis.
It is estimated that every year more than 20 million patients need palliative care at the end of life. Some 6% of these are children. The number of people requiring this care rises to at least 40 million if all those that could benefit from palliative care at an earlier stage of their illness are included. Hospice and palliative care often encompasses some support to family members, which would more than double care needs.
In 2011, approximately 3 million patients received palliative care, the vast majority at the end of their life. Although most palliative care is provided in high-income countries, almost 80% of the global need for palliative care is in low- and middle-income countries. Only 20 countries worldwide have palliative care well integrated into their healthcare systems[1].
“The Atlas shows that the great majority of the global need of end-of-life care is associated with noncommunicable diseases such as cancer, heart disease, stroke and lung diseases,” says Dr Oleg Chestnov, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health. “While we strengthen efforts to reduce the burden of the biggest killers in the world today, we must also alleviate the suffering of those with progressive illness who do not respond to curative treatment.”
The Atlas calls on all countries to include palliative care as an essential component to every modern healthcare system in their moves towards universal health coverage. This means addressing barriers such as:
1) lack of policies recognizing palliative care and the need for care both at the end of life and during progressive illnesses;

2) lack of resources to implement services, including access to essential medicines, especially pain relievers;

3) lack of knowledge of health care professionals, community volunteers and members of the public about the benefits of palliative care.

“Our efforts to expand palliative care need to focus on bringing relief of suffering and the benefits of palliative care to those with the least resources,” adds David Praill, Co-Chair of the WPCA. “This will take courage and creativity as we learn from each other how to integrate palliative care into existing but very limited healthcare systems.”

Last week, the Executive Board of WHO called on countries to strengthen palliative care and to integrate it into their healthcare systems. It is expected that the 67th World Health Assembly will discuss the subject in May 2014.

The importance of palliative care is being emphasized by the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020 and the most recent WHO essential medicines list that includes a specific section on medicines for palliative care.

* * *

Global Action Plan for the Prevention and Control of NCDs 2013-2020:

[1] Australia, Austria, Belgium, Canada, France, Germany, Hong Kong Special Administrative Region, Iceland, Ireland, Italy, Japan, Norway, Poland, Romania, Singapore, Sweden, Switzerland, Uganda, United Kingdom, United States of America