- September 18, 2020
2:30 pm - 4:30 pm
Our next peer group call is scheduled for Fri. July 17th at 2:30 pm The length of the call depends on you, but no more than an hour. This is your time to check in with each other and share information. These calls will continue bi-weekly if you want them.
Please call 1 319 527 3512, code 610342# on Friday at 2:30 pm.
- Please take a look at the attached State of New Hampshire emergency order #42 that was released this week to provide more help in nursing homes. I would like your comments on the section titled “Comfort Care and End of Life Care”. Two of the three bullet points describing what the newly trained “health partner” is able to do has no substance at all. In eight hours of total training for this supplemental position, there seems to be little room for any real training in end of life care. More to the point – if they need this assistance – wouldn’t they be better off letting some of the hospice team in to help?? Please let me know if you had seen this and if you might reach out to the facilities that you work with to discuss options.
Summary of Hospice Administrator call – June 19, 2020
- COVID 19 testing of staff ranges from not required by some agencies to mandated 2 step testing by other agencies. When it is mandated, staff do not incur the cost.
- Genesis facilities are requiring that anyone visiting their facilities be serial tested.
- Recent guidance from CMS recommends that all hospice staff going into LTC facilities be tested for COVID 19 before providing visits. CMS further states that it is the facilities responsibility to provide testing of hospice staff. Attendees on the call felt that this was unrealistic. One administrator called state DHHS for clarification and was told that as long as hospice staff follow the screening procedures before entering a facility they do not need to be tested.
- States that are requiring serial COVID testing before admission to LTC facilities report that the state is paying $50 – $100 for hospice staff to be tested. Could the Alliance ask our state officials to provide necessary testing for hospice staff to relieve the burden on both provider groups?
- Janice reported that she and Gina are reaching out to state partners as needed on behalf of providers with regard to LTC visitation issues.
- Discussion about whether LTC facilities will see the CMS guidance for COVID 19 testing of hospice staff as another reason to keep hospice staff from visiting and prevent new referrals to hospice.
- The recently released CMS guidance for hospice also states that if a LTC facility will not allow hospice staff to visit in-person, the patient should be discharged from hospice services. NAHC reached out to CMS for clarification and was told that hospice does not need to discharge. They advise providing detailed documentation of reasons for limited in-person visits.
- Some attendees on the call report an overall decline in new referrals for LTC while others report no decline in referrals except in facilities with a COVID outbreak. Also reported was inconsistent access to in-person visits in facilities. Visits by telephone and zoom are primary mode of service.
- In general – hospice referrals are picking up
- General issues related to COVID 19 for staff include: PPE very uncomfortable in the heat of summer, flexible work hours and work assignments are key to keeping everyone employed, policies for staff regarding travel and need for self-quarantine vary among agencies, also staff concerns about the future as pandemic has no end in sight.
** NHPCO will provide a draft letter in response to the 2021 Proposed Rule this month. Their comments will focus on asking for a delay in the hospice election statement and addendum requirement that is due to be in effect on Oct. 1 of this year. I will send the letter to you for review when I receive it.
Director of Hospice & Palliative Care
Home Care, Hospice & Palliative Care Alliance of NH