Managing the Hospice Cap

Managing the Hospice Cap 

The hospice cap is a per person payment Medicare will make for the hospice benefit. The cap amount is adjusted annually. Hospice providers must be aware of the hospice cap and have systems in place to effectively monitor the cap, know how the cap is computed, and recognize a hospice organization’s potential liability under the cap.

$15.00

Hours: 1.00
REL-PAC-WB-MHC

Certificates

Certificates provided by accrediting body (3 Match)

Texas Health and Human Services Commission

1.0 HOURS


Texas HHSC has determined that Relias Learning’s submitted training meets or exceeds the minimum standards for HCSSA administrator training in the following categories: Hospice. Texas HHSC also recognizes Relias Learning provides continuing education for administrators and alternate administrators. This activity is approved for 1.00 contact hours.

National Association of Long Term Care Administrator Boards (RCAL)

1.0 HOURS


This educational offering has been reviewed by the National Continuing Education Review Service (NCERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 1.00 clock hours. If you have any feedback regarding the NAB approved continuing education programs, send your email to the following address: [email protected]

National Association of Long Term Care Administrator Boards (NHA)

1.0 HOURS


This educational offering has been reviewed by the National Continuing Education Review Service (NCERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 1.00 clock hours. If you have any feedback regarding the NAB approved continuing education programs, send your email to the following address: [email protected]

Course Details

Course Code: REL-PAC-WB-MHC
Hours: 1
Type: Online Course
Content Expiration Date: 1/31/2022
Learning Objectives:
Explain the hospice aggregate cap and how cap liabilities occur.
Determine cap liability computations.
Develop a process for continuous cap liability monitoring.

Outline:


Section 1: Introduction
About This Course
Learning Objectives
Section 2: What Is the Aggregate Hospice Cap?
A Simple Rule, A Complex Reality
The Cap Year
Growth in Cap Hospices: Be Prepared
Implications of the Cap
An Illustration: Discriminatory Nature of the Cap
Review
Summary
Section 3: Computing the Cap
Methods for Calculating the Cap
Review
Summary
Section 4: Surveilling for Cap Liabilities
Self-Reporting
Preparing the Annual Cap Report
Cap Liability Computation
Review
Summary
Section 5: Managing the Cap
A Straightforward Process?
Reopening Cap Determinations
What Is the Ultimate Cap Liability?
Monitoring Cap Status: A Simple Tool for Tracking Trends
Lifetime Length of Stay (LLOS)
An Illustration of LLOS
Calculating LLOS: PS&R Data
Estimating Cap Liabilities: Beneficiary Count Erosion
Estimates Made Before the Cap Year Is Over
Streamlined Method for Estimating Cap Liability
Tracking Historical Erosion Method
Current and Projected Liability Status
Addressing Cap Liability
Review
Summary
Section 6: Conclusion
Summary
Course Contributors
Resources
References

Instructor: William T. (Ted) Cuppett, CPA, Director

William T. (Ted) Cuppett, CPA is the founder of The Health Group, LLC, which provides a vast array of financial and consulting services to healthcare providers. For nearly 10 years Ted served as Home Health/Hospice Niche Leader for Dixon Hughes Goodman PLLC, one of the twenty largest CPA firms in the United States.

Ted has served healthcare clients of all types since 1977, providing reimbursement consulting, merger/acquisition assistance, strategic planning, litigation support and compliance consulting. Clients served include hospitals, nursing homes, home health agencies, hospices, RHC/FQHCs, and other healthcare providers. He managed numerous healthcare audit engagements on key healthcare clients while a Member at Dixon Hughes Goodman PLLC.

Ted speaks regularly on healthcare financial issues and has served in numerous capacities for professional organizations including membership on the Health Care Expert Panel, Healthcare Audit and Accounting Guide Revision Task Force, Management Consulting Services Executive Committee, and Management Consulting Services Practice Standards Subcommittee of the American Institute of Certified Public Accountants. Ted is presently a member of numerous professional organizations including the American Health Lawyers Association.

Ted currently serves as Director with Gray Griffith Mays – Morgantown PLLC (GGM), an affiliate of The Health Group, LLC. GGM provides accounting, tax, audit, business valuation, and other financial consulting services to clients across the country. Together, The Health Group, LLC and GGM serve clients in 41 states, Canada, and Puerto Rico.

Disclosure: William T. (Ted) Cuppett, CPA, Director has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Staff Writer: Susan Heinzerling, RN, CHPN
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.
Target Audience:
The target audience for this course is: Administrators; in the following settings: Hospice, Palliative Care.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Accommodations
If you require special accommodations to complete this module, please contact Relias Customer Support here.