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This Minute highlights some very key components of the Hospice Proposed Rule that needs your feedback!

Hello, everyone, and welcome to our Monday Minute. Today I would like to review with you some very key components of the Hospice Proposed Rule and things we feel extremely important that hospices comment on during the comment period. The comment period will end on June 7, 2021. You want to make sure that you get those comments together and get them issued or sent in to CMS for consideration in finalizing this proposed rule. What I want to make sure you hear clearly is that they want to hear positive feedback as well as negative feedback. Obviously, if you feel in opposition of something, you definitely need to comment. But if you have positive comments, which I’m going to mention a few things today that you likely do have positive comments on, they need that feedback and want that feedback. The first thing is related to the proposed changes to the election statement addendum. The election statement addendum that went into place, October 1, 2020, includes some proposed changes that would definitely help agencies deal with this more effectively. First of all, the original language, the current language is that if a patient requests the addendum upon admission that you have five days in order to get that completed and get it to the patient for signature. If the patient requested, after care has begun, then you only have three days. Technically, the rule today says 72 hours to get that to the patient. The changes in the proposed rule include that if they request it upon admission, of course, it is still the five days, but also once they have requested it, if they requested in that initial five days of care, when the Comprehensive Assessment is not yet due, then you would still have five full days to provide it to them, which is definitely a positive change. The other positive change is changing the terminology from 72 hours to three days. For the situation when the patient requests the addendum aftercare has begun. Both are very important updates for hospices. In addition to that, they granted or gave us clarification in the proposed rule about the reality that if a patient refuses to sign the addendum, then it will be fine as long as you have documented clearly that it was delivered, and the delivery was within the allotted time period.

They’re also requesting information from hospices related to how you are making the decision as to what is considered related or unrelated to the terminal condition and related conditions. It’s very important that you share this information as much as possible because it could affect what they make as concrete clarifications and what we will need to use in the future. They are also looking for information from hospices as to how or if there are care decisions being made as a result of this addendum and its requirement. The last thing I want to point out regarding the hospice proposed rule and comments, that they really need to hear from you about, is concerning the CoP waivers that are currently in place with the COVID-19 Public Health Emergency. This includes that if a hospice aide needs a competency evaluation that you may use a pseudo patient, that right now is only during the waivers or during the COVID emergency. They are looking to permanently allow hospices to use pseudo patients in those competency evaluations. They are also proposing that if an aid is identified, to have a deficiency, during an evaluation, that you as the hospice would only have to do an additional competency evaluation on that specific item in which a deficiency was identified. Right now the current rule is that if deficiencies are identified a complete, comprehensive competency evaluation would have to be completed. So this would allow hospices to do a more focused competency evaluation, just to reconcile the problem at hand.

So I want to again, encourage you to send in your comments regarding the proposed rule, so that those comments can be considered as CMS finalizes this rule. Again, the due date is June 7. I also want to say Happy Nurse’s Month, and this past week, Happy Nurse’s Day, to all you amazing, amazing heroes in the home health and hospice industry. We are so very appreciative and thankful. And obviously if you’re a nurse that works in a hospital or SNF or any other element, we are totally appreciative and could not do what has been done through this Public Health Emergency without you. Thank you all for participating today. And I hope you have an amazing week.

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