Course Code: REL-PAC-WB-RRPCESA
Hours: 1.5
Type: Online Course
Content Expiration Date: 12/31/2026
Learning Objectives:
Identify the regulatory guidance on conditions, items, services, and drugs and financial responsibility.
Recall how relatedness is determined based on diagnoses, conditions, and/or symptoms.
Describe the steps for composing the physician statement for inclusion on the Patient Notification of Hospice Non-Covered Items, Services, and Drugs (Addendum).
Outline:
Objectives
Setting the Stage
Medicare Spending on Hospice Care
Medicare Spending Outside the Hospice Benefit
OIG Data Brief
Increase in Public Awareness
Hospice Coverage
CMS Relatedness Statements - 1983 Final Rule
CMS Relatedness Statements - 2018 Fed Reg
CMS Relatedness Statements - 2019 Fed Reg
Determining Relatedness to the Terminal Prognosis: Process Flow
Co-Morbidities & Secondary Conditions
Hospice Patients
Mr. Short of Breath
Determination of Hospice Medication Coverage
Mr. Short of Breath
Mr. Short of Breath Example Documentation
Mr. Short of Breath Continued
Mr. Short of Breath Unrelated Example Documentation
The Election Statement and Relatedness
418.24 Election of Hospice Care
Patient Notification of Hospice Non-Covered Items, Services, and Drugs
Trouble Shooting Relatedness
Questions/Answers
References
Subject Matter Expert: Lauren Templeton, D.O., HMDC
Dr. Lauren Templeton has been a Physician Consultant with Weatherbee Resources since 2017. As a physician since 2009 and a hospice and palliative medicine physician since 2012, Dr. Templeton began her career in internal medicine, but soon thereafter was drawn to end-of-life care due to its overall philosophy and her passion for ensuring a dignified death for her patients. As a hospice medical director and Hospice Medical Director Certified physician, she is perfectly positioned to assist your hospice physicians with compliance education!
Dr. Templeton currently works in hospice as the medical director for a medium size not-for-profit hospice based in Texas. In this role, she assists with compliance, quality improvement and documentation review. She continues to participate in clinical care managing hospice patients in both the home care and inpatient setting.
Dr. Templeton also serves as associate medical director for the Palliative Care Department at a local medical center, as well as, serving on the foundation board, medical executive committee, and ethics committee for the same facility.
Dr. Templeton’s mission is to help support hospices by educating on the role of the hospice medical director from a regulatory and clinical perspective. She has served as a task force member and item writer for the Hospice Medical Director Certification Board from which she is certified. She continues a robust educational program within her own hospice program and is a regular speaker with the Texas New Mexico Hospice Organization.
Dr. Templeton is an advocate of the hospice benefit and speaks to groups such as the Alzheimer’s Association about hospice care. She currently serves as a member of the NHPCO Regulatory Committee assisting in advocating for hospice providers across the country.
As a Physician Consultant with Weatherbee, Dr. Templeton assists hospice providers and physicians with compliance services as well as:
- Orientation for new medical directors and team physicians.
- Education, coaching, and mentoring for hospice physicians.
- Consulting on complex issues (e.g., making appropriate coverage determinations; ethical issues; challenging pain and symptom management cases; admission, recertification, and level of care eligibility; etc.).
- Auditing physician and other clinical record documentation (e.g., thoroughness and appropriateness with regard to hospice eligibility; compliance with regulatory requirements; appropriateness with regard to coverage determinations; etc.).
- Re-tooling the interdisciplinary group meeting and related processes.
- Preparing physicians for Administrative Law Judge (ALJ) hearings.
- Providing expert witness testimony in ALJ hearings and other legal matters involving patient eligibility.
Dr. Templeton graduated from Pennsylvania State University with a Bachelor of Arts and received her doctor of osteopathy from Ohio University College of Osteopathic Medicine in 2009. She completed a residency in Internal Medicine and is board certified with the American College of Osteopathic Internists. She completed a fellowship in Hospice and Palliative Medicine at Texas Tech University and became board certified in hospice and palliative medicine in 2013. She obtained additional certification with the Hospice Medical Director Certification Board in 2018.
In November 2022, Dr. Templeton earned the designation Fellow of the American Academy of Hospice and Palliative Medicine (FAAHPM). This is the highest honor that can be bestowed upon a member. The Academy is the professional organization for physicians specializing in hospice and palliative medicine, nurses, and other healthcare providers.
Target Audience:
The target audience for this course is: Nurses; in the following settings: Post-Acute Care.
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All courses offered by Relias Learning, 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.
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.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.