Outline:
Section 1: Introduction

About This Course

Learning Objectives

Section 2: The Certification & Recertification of Terminal Illness

The Initial Certification and Recertification of Terminal Illness

The Face-to-Face Encounter

Who Performs the Face-to-Face Encounter?

Exceptions to the Face-to-Face Encounter Requirement

Time Frames for Certifications and Recertifications

Certification and Recertification Content

Additional Certification and Recertification Content

Review

Summary

Section 3: Regulatory Requirements

The Origin of the Physician Narrative

Introduction to the Regulatory Requirements

The Attestation and the Narrative

Signatures

The Narrative Summary Statement

Narrative Format

Elements of an Optimal Narrative: Elements 1-2

Elements of an Optimal Narrative: Elements 3-9

Review

Summary

Section 4: Initial Certification Narratives

Clinical Scenario Examples

Initial Certification Narrative: The Certain Certification, Example 1

Initial Certification Narrative: The Certain Certification, Example 2

Initial Certification Narrative: The Certain Certification Example 2 Continued

Initial Certification Narrative: Eligibility Supported by Medical Records, Example 1

Initial Certification Narrative: Eligibility Supported by Medical Records Example 1

Initial Certification Narrative: Eligibility Supported by Medical Records, Example 2

A Note about the Eligibility Supported by Medical Records, Example 2

A Note about Dementia and Eligibility Codes

Initial Certification Narrative: No Medical Records Available

Initial Certification Narrative: No Medical Records Available, Example 1

No Medical Records Available, Example 1 Narrative

A Note About Debility and Adult Failure to Thrive

Initial Certification Narrative: No Medical Records Available, Example 2

Review

Summary

Section 5: Recertification Narratives & Narratives for the Deceased

Recertification into the Advanced Benefit Period: Clearly Eligible, Example 1

Clearly Eligible Example 1 Recertification Narrative, Continued

Clearly Eligible Example 1 Recertification Narrative, Continued

Recertification into the Advanced Benefit Period: Clearly Eligible, Example 2

Clearly Eligible Example 2 Factors to Consider

Recertification into the Advanced Benefit Period: Slow Decline Example

Slow Decline Example Factors to Consider

Slow Decline Example In-Depth Analysis

Person is Deceased at the Time the Physician Writes the Narrative

Person is Deceased at the Time the Physician Writes the Narrative Example

Review

Summary

Section 6: Conclusion

Summary

Course Contributors

Resources

References

Congratulations!

Dr. Aletha Tippett received her BS in chemical engineering from the University of Missouri in 1975 and her MD from the University of Cincinnati in 1997. Dr. Tippett has done wound care for 20 years and has treated over 15,000 wounds. Her main areas of focus in wound care are limb salvage and pressure ulcer prevention and treatment and she brings a bio-engineering approach to these. She has been honored with numerous awards in the healthcare community and is a published author and international speaker and teacher on wound care topics. She is president of the Hope of Healing Foundation, dedicated to limb salvage and novel wound therapies. She is a member of the International Biotherapy Society and is an active "biotherapist", using maggots and leeches in her wound care practice. Dr. Tippett is also active in hospice and is a certified hospice medical director for Brookdale Hospice in Dayton, Ohio. Disclosure: Aletha W. Tippett, BSChE, MD, ABFP, ABHPM, AAPM, WCC, CWS has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.

Susan Heinzerling began her nursing career as a Med/Surg nurse. Renal patients in acute care, with multiple chronic conditions and repeated hospitalizations inspired her practice of hospice nursing where she began as Hospice Admissions Nurse and later became a Hospice RN Case Manager. Susan has practiced hospice nursing in both a large, urban area and in a rural setting. Susan earned a B.S. in Biology and B.S. in Nursing from the University of North Carolina at Chapel Hill and a Master's degree in Physiology from North Carolina State University. She became a Ph.D. Candidate in Immunology at the University of South Alabama. Her research experiences in the biomedical sciences led to an interest in evidence-based practices. Disclosure: Susan Heinzerling, RN, CHPN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.