The Physician Narrative in Hospice Care

Outline:
Section 1: Introduction

About This Course

Learning Objectives

Section 2:

Initial Certification and Recertification of Terminal Illness

The Face-To-Face Encounter

Who Performs the Face-To-Face Encounter?

Face-To-Face Encounter Exceptions

Time Frames

Certification and Recertification Content

Review

Summary

Section 3: Regulatory Requirements

Physician Narrative

Regulatory Requirements

The Attestation and the Narrative

Signatures

Narrative Summary Statement

Narrative Format

Optimal Narrative Elements

Review

Summary

Section 4: Initial Certification Narratives

Clinical Scenario Examples

Initial Certification Narrative: The Certain Certification

Initial Certification Narrative: Eligibility Supported by Medical Records

Dementia and Eligibility Codes

Initial Certification Narrative: No Medical Records Available

Debility and Adult Failure to Thrive

Initial Certification Narrative: No Medical Records Available

Review

Summary

Section 5: Recertification & Deceased Narratives

Advanced Benefit Period Recertification: Clearly Eligible

Clearly Eligible Recertification Narrative

Advanced Benefit Period Recertification: Clearly Eligible

Advanced Benefit Period Recertification: Slow Disease Progression

Slow Decline Factors

Slow Decline Example

The Physician Narrative for the Deceased Individual

Review

Summary

Section 6: Conclusion

Course Summary

Course Contributor

Resources

References



 

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 no Relevant Financial or Non-Financial Relationship with ineligible companies to disclose.

Elizabeth Vaccaro earned her Bachelor of Science in nursing from Kean University. She has worked as a Multiple Sclerosis Nurse Educator. Elizabeth has worked in a variety of healthcare settings from the hospital to the pharmaceutical industry which has allowed her to have a great appreciation for all the challenges that span the healthcare field.  She has practiced in the hospice setting for nine years in a variety of roles from Case Manager, Educator, and Director of both inpatient and home care hospice.  Disclosure: Elizabeth Vaccaro, BSN RN discloses the following potential conflict of interests/commercial interests: Relevant Financial Relationship with Relias LLC as a Salaried Employee All of the relationships listed for this individual have been mitigated.Relevant Non-Financial Relationship with No Entities Exists as a Contributor All of the relationships listed for this individual have been mitigated.