Leading a Hospice Volunteer Team

Leading hospice volunteers is not just our job; it is our passion.  For me, it is essential to approach this very important work with passion – both for the reasons for which volunteers are needed, and especially for the gift that volunteers bring.  Thankfully, this is a very easy task, because undoubtedly we find – over and over again – that our lives are enriched by working with an awesome teams of volunteers.  Secondly, I’m encouraged to remember that those who commit to being a hospice volunteer are stating that they are willing to serve, without pay, to improve the quality of life for others.  And it is our privilege and responsibility, as leaders of volunteers, to come alongside these willing individuals with the passion and commitment they deserve.

Think about the gift!  Hospice volunteers have said – either to themselves or to us – that they are willing to walk with others on their end-of-life journey.  They are friendly visitors, holding the hand of a patient in a skilled nursing facility. They are envelope stuffers, assuring that those who are grieving receive valuable resources and support.  They are errand runners, picking up groceries for family members who just don’t have time to get away.  They are support group assistants, sharing their own walk of grief with others in a healthy way which helps them to navigate their own journey.  They are phone connections, assuring families that needed services and supplies are available exactly when and how needed.  They are fundraisers, championing your organization to have funds available to meet benevolent needs of patients and families.  They are vigil keepers, believing that no one should die alone and being there, day or night, simply to be a presence. They are Veterans, committed to honoring those at end of life who have served our country and protected our freedoms. They are teenagers.  They are retired. They are working people with very busy lives. They are all of this and more. They are givers – of time, of passion, of self.

To those of us who are leaders of volunteers – may we enjoy each and every day of our work, and recognize our work as the valued profession that it is.  Let us take time every day to thank a volunteer, to encourage them in their work. There is great joy in the successful leadership of volunteers. There is great joy in paving the way for others to be able to give from their hearts to those who are at end of life.  I am blessed… we are blessed!

By Leanne Porterfield, CVA
Coordinator of Volunteers, Homeland Hospice 

National Volunteer Week is April 10 - 16, 2016.

Thoughts on OIG Report on Hospice Inpatient Care

On Thursday March 31, 2016, the HHS Office of Inspector General issued a report on the use and misuse of hospice inpatient care in the Medicare Hospice Benefit. The study was undertaken as part of an ongoing effort at OIG to prevent inappropriate claims for hospice general inpatient care (GIP), including care being billed but not provided and beneficiaries receiving care they do not need.

As the oldest and largest leadership organization representing hospice and palliative care providers and professionals, NHPCO continues to welcome appropriate oversight of the field and works continually with its members to ensure their awareness of and compliance with all hospice related rules and regulations. NHPCO has also worked closely with Congress and CMS to promote policy changes that stem the abuses referenced in the report, and ensure a high quality hospice experience for consumers. 

Specifically, NHPCO recommends that hospices:

• Have a process and procedure for determining eligibility for the GIP level of care, that they document the reasons that GIP is appropriate for each patient, and evaluate continued eligibility for GIP EVERY DAY with documentation in the medical record that can be easily reviewed.
• Obtain a written physician order for a change in level of care. 
• Review use of GIP and the length of stay for each patient at the GIP level of care on a monthly basis, with documentation about the review in each patient’s medical record. 
• Review the development of plans of care for patients admitted to and continuing in the GIP level of care.
•  Develop a process for reviewing all medications, check and double check how medications are paid for and ensure that contract providers are billing appropriately.
• Review and update your processes at inpatient facilities to ensure daily evaluation of eligibility, detailed documentation to prove continued eligibility and accurate and complete care plans. 

NHPCO will continue to work with member organizations, policymakers, and other stakeholders to ensure that hospice claims are billed appropriately, and that beneficiaries experience high quality, compassionate care at the end-of-life.

See NHPCO's Regulatory Alert on the new OIG report for additional analysis and summary of the report.

2016 Virtual Conference: Call for Poster Presentations

The National Hospice and Palliative Care Organization, American Academy of Hospice and Palliative Medicine, and Hospice and Palliative Nurses Association will host the 2016 Virtual Conference, Complex Challenges on the Front Lines: Effective Approaches to Complex Cases, from August 9 – 11, 2016. 

NHPCO, AAHPM and HPNA are seeking poster submissions for the Virtual Poster Gallery to be part of this year’s Virtual Conference. Posters will outline approaches and solutions to clinical challenges that hospice and palliative care professionals face in their work with patients and families.

Submissions for poster presentations will be accepted through April 29, 2016. Hospice and palliative care practitioners and researchers are encouraged to be a part of the conference’s expert and distinguished faculty by submitting a poster presentation. Presenters are not required to be present. A sample of one of the poster presentations from the 2015 Virtual Conference is available online.

Learn more about the Virtual Conference Call for Posters online, including the conference learning objectives.

Registration for the 2016 Virtual Conference is now open. 

Building Physician/Executive Leadership

Building an Exceptional Physician/Executive Leadership Team is a special one day workshop offered by NHPCO in collaboration with the American Academy of Hospice and Palliative Physicians that will help hospice and palliative care physicians and executive leaders build an effective working relationship. Building an Exceptional Physician/Executive Leadership Team will be held Wednesday, April 20, 2016, from 8:30am to 5:00pm.

Regardless of whether a professional has “chief” in his or her title or not, every hospice program has a physician and executive leader. This new program is designed by national hospice leaders to assist senior executives in developing and strengthening this key relationship. The esteemed faculty offers thoughts on the importance of this vital relationship and why it is crucial to a highly functioning hospice organization. 

As the hospice industry increasingly demands measureable clinical excellence and sound business management, synergy and mutual support between the CEO and CMO are essential. This conference will provide a shared foundation from which these key leaders can join forces to ensure a successful, viable organization. 

Barbara Ivanko, LCSW CHPCA
President and CEO
Family Hospice and Palliative Care, Pittsburgh PA

Everything rises and falls on leadership and the two top leaders in most hospice organizations are the CEO and the CMO.  Their competency as leaders and their chemistry as a team will make or break most organizations.  That is why this conference is a must attend.  Get the tools and techniques you need to ensure your organization is successful in that realm.

Chris Comeaux
President/CEO
Four Seasons Compassion for Life, Flat Rock NC

"The CMO just doesn’t understand the pressing financial situation we’re in," states the CEO. "The CEO doesn’t get the fact that we’re overworked and understaffed," says the CMO. These are the type of comments I hear all the time. To have an effectively run hospice organization it is critical to have these two positions working together to enhance overall operations, hence the creation of the CEO and CMO Intensive.

Janet H. Bull, MD FAAHPM
Chief Medical Officer
Four Seasons Compassion for Life, Flat Rock NC

A right decision today may not be right tomorrow. In the new health care economy, CEO-CMO functionality is the equivalent of the oil pipe in an industrial economy. Developing, nurturing, and building a strong, agile, and skilled CEO-CMO leadership team should be a key organizational priority. Attending this course could be the best investment your hospice could ever make.

James A. Avery, MD FACP FAAHPM
CEO/President
Hospice of the Piedmont, Charlottesville VA

Learn how to leverage effective leadership within the “white water rapids” of today’s hospice environment. Online registration for the CEO-CMO intensive is open until March 31; after that date, on-site registration will be available. This intensive is being offering in conjunction with NHPCO’s annual Management and Leadership Conference, April 21 – 23, 2016, at the Gaylord National Harbor Resort and Convention Center in National Harbor, Maryland. 

New Strategic Opportunities for Hospice

On Tuesday, March 8, Medicare announced a new five-year initiative that has the potential to radically change the way it pays for outpatient drugs. This is just another part of CMS’ ongoing migration of provider incentives from volume to value. These changes are already altering the landscape for hospices and their relationships with professional referral sources, including hospitals, health systems, physicians and ACOs.

Healthcare payment reform is creating a new set of challenges and opportunities for hospitals and health systems. This seminar will help the hospice administrator evaluate opportunities to become an active partner with hospitals, Accountable Care Organizations (ACOs) and other at-risk organizations in your market. In this session, you’ll gain clarity and a sense of direction for your organization’s strategies by learning from the perspective of three speakers: a hospice strategist, a hospice provider, and an ACO physician and owner.

Are you comfortable that you understand all the implications for your hospice?

In April, at the NHPCO Management and Leadership Conference, Sue Lyn Schramm, M.A., Director of NHPCO Edge, will be leading a half-day preconference session on the topic of hospice strategies for working with ACOs. Taking Hospice Skills Upstream: New Ways Hospice Can Partner with Health Systems and ACO’s is being presented on Wednesday, April 20, 9:00am - 12:00pm and online registration is open until March 31, 2016.

Of additional interest, attendees may want to consider combining attendance at this cutting-edge preconference session with the 2^nd Annual Executive Business Summit, Beyond the Benefit: Delivering on the triple aim in healthcare through palliative care, happening April 20 from 5:00 - 6:00pm (separate registration is required.)

Sue Lynn Schramm, MA
NHPCO Director, Consulting Services

See Sue Lyn Schramm's article in Spring 2016 NewsLine on ACOs and Alternative Payment Models.

Tuckson and Schumacher Talk about Changing Healthcare Marketplace

In anticipation of Dr. Reed Tuckson's keynote address at NHPCO's upcoming annual Management and Leadership Conference, "Leading through the Currents of Change" (April 21 - 23, 2016), he spoke with Don Schumacher about some factors that may serve the hospice and palliative care community as it integrates more fully with the nation's medical care delivery system.

Dr. Tuckson emphasized that the time is right or palliative and hospice care to be an essential component of the modern delivery system in the U.S. Medical care delivery is moving from volume-based to value-based, and quality issues - including care settings - are becoming increasingly important to all providers. Hospice and palliative care are well positioned and to add to the changes in care delivery. "If there is ever a time for this field to blossom this is the time," said Dr. Tuckson.

Key points from their discussion
Hospice and palliative care meet the needs and values of the patients they serve and represent better coordination of care. Additionally, the movement towards team based care - which is integral to the hospice and palliative care model - are becoming increasingly important. 

We are seeing the move to whole patient-centered care and hospice and palliative care bring dignity, respect and control to patients and family caregivers.

In recent years there have been many changes in the healthcare delivery system, much because of the Affordable Care Act. There is awareness of the need to be more effective further upstream. Dr. Tuckson spoke of his interactions with people across the country and said he is learning that people need a lot of support in understanding and engaging on related end-of-life issues. Making wishes known and engaging in advance care planning is, ultimately, a positive step for patients and their families. Providers need to create a fertile environment for such conversations and ensure that the appropriate tools have been developed and are available.

The time is right to develop partnerships between community-based hospice and palliative care programs and hospitals and physician organizations, noted Dr. Tuckson. "The focus on value and patient satisfaction provides an entirely different incentive for partnership," he noted.

Dr. Tuckson spoke with Don via Skype.

There is much opportunity. The challenge is how do we translate vision into tangible practices.
Additional clips from their conversation are available online:

• Being Proactive
• The Importance of Partnerships
• Final Thoughts

Dr Tuckson will deliver the plenary session on Friday, April 22 as part of the Management and Leadership Conference. Registration for the conference, being held at the Gaylord National Harbor Resort & Convention Center in National Harbor, Maryland, is now open.

Reed Tuckson, MD, is the managing director of Tuckson Health Connections, LLC, a health and medical care consulting business that brings people and ideas together to promote optimal health outcomes and value through innovation and integration across the field. Previously, Dr. Tuckson enjoyed a long tenure as executive vice president and chief of medical affairs for UnitedHealth Group.

The Story of a Generation of AIDS Survivors

In the early years of the AIDS Pandemic, many hospices provided care to the dying when mainstream medical providers were not offering care out of fear of the many unknowns associated with HIV/AIDS. 

Reporter Erin Allday has written a moving account of a generation of people who have survived living with AIDs in San Francisco. Published this week by The San Francisco Chronicle, "Last Men Standing" includes a number of pieces that look at the Pandemic that defines a generation. They include: 

• an extensive articlea documentary film to be released April 8
• a documentary film to be released April 8
• and profiles of survivors. 

"They had the remarkable luck to survive AIDS, and the brutal misfortune to live on. They outlived an epidemic, but San Francisco’s AIDS survivors are still fighting for their lives," reads the introduction to the special project available online.  

 

In his article, Allday writes:  "Since 1981, when the first man succumbed to a disease that did not yet have a name, AIDS has taken more than 20,000 lives in San Francisco, most of them gay men, most of them decades too soon."

Near the conclusion of the article, readers are reminded, "In a life defined by a plague and measured in loss and pain, in fear and loneliness, sometimes it’s the smallest steps forward, the briefest moments of gratitude, that matter most. Waking up to the sunlight. Taking someone’s hand."

A brief description of the documentary film reads, "Surrounded by the ghosts of a generation lost to the AIDS epidemic, eight gay men search for meaning in a life they never expected to have." This is the San Francisco Chronicle’s first feature-length documentary, which will be released April 8 at the Castro Theatre in San Francisco.  A preview of "Last Man Standing" is available online.

This special report from The San Francisco Chronicle has received much attention on social media.