Hospice:
LONG-AWAITED COPs REVAMP PLEASES HOSPICES
Published on Mon May 12, 2008
But providers have a lot of work ahead to assure compliance.
Hospices will need every second of their six-month grace period to gear up for their newly finalized Medicare conditions of participation.
The Centers for Medicare & Medicaid Services issued the CoPs final rule in the June 5 Federal Register, after first proposing the new standards in May 2005. They will take effect Dec. 2. The lengthy regulation contains wide-ranging changes to the CoPs, many of which have been unchanged since the hospice benefit's inception in 1983.
"Without a doubt, after 25 years ... it was time to update the regulations and reflect the current thinking on patient care during end-of-life," says hospice consultant Beth Carpenter with Beth Carpenter and Associates in Barrington, IL.
"The CoPs ... will require that hospices en-gage in considerable compliance efforts, [but] overall they contain a strong emphasis on promoting quality patient care," praises attorney Mary Michal with Reinhart Boerner Van Deuren in Madison, WI. Hospices Talked, CMS Listened Hospices seem to approve of the new regulations. "We were pleased that many of the suggestions made by [the National Hospice and Palliative Care Organization] during the public comment period for the proposed rule were incorporated into the final rule," NHPCO's Judi Lund Person tells Eli.
"The final regulations are significantly better than the current CoPs and the areas of weakness in the proposed regulations have been fixed," cheers hospice consultant Heather Wilson with Weatherbee Resources in Hyannis, MA.
For example: CMS loosened up a bit its timeframe for assessments. The CoPs will now require hospices to conduct an initial patient assessment within 48 hours instead of the proposed 24 hours. And providers must complete comprehensive assessments within five days, up from the proposed four.
"The move from 24 to 48 hours for the initial assessment was a welcome change and viewed as doable by providers," Person says.
CMS recognized "the need for sufficient time to conduct both the initial and comprehensive assessments," Michal says. Hospices also must conduct reassessments within 15 days, up from the proposed 14.
Even those more relaxed timeframes will keep hospices hopping. "The pace at which hospices will process patients for end-of-life care will certainly pick up!" Carpenter notes. Those quicker deadlines will lead to improved patient care, Carpenter believes.
Other provisions in the CoPs include: • Patient rights. In announcing the new regulations, CMS is pushing the topic of patient rights. "Medicare beneficiaries with terminal illnesses have their right to determine how they receive end-of-life care outlined for the first time" in the CoPs, CMS says in a release. The conditions "include explicit language on patient rights that had not existed under the previous regulations."
Reprieve: CMS relented on the requirement that patients show understanding of the patient rights paperwork, NHPCO [...]
