Stella1688

Latest Activity

1. Medicare Diagnosis Changes

   Stella1688 replied to Stella1688's topic in Hospice

   Hi SuesquatchRN...just to put this out there, there is a bill in congress requesting increased funding for hospice and palliative education to be mandatory in all accredited medical and nursing schools. It has a poor chance of passing but sometimes i...

2. Medicare Diagnosis Changes

   Stella1688 replied to Stella1688's topic in Hospice

   I would be leery too! That is still quite functional and inappropriate for a dementia primary dx

3. Medicare Diagnosis Changes

   Stella1688 replied to Stella1688's topic in Hospice

   Thanks PamRNinTX, I have often used 294.21 or 331.0 if their chart specifically says Alzheimers. It seems like Senile Degeneration of Brain is a safe bet though.

4. Medicare Diagnosis Changes

   Stella1688 replied to Stella1688's topic in Hospice

   I'm more curious on everyone's views on dementia as a terminal diagnosis. I think most of us agree that debility is way overused. What about the patient with advanced dementia that can no longer swallow and continues to aspirate, has had a >10% we...

5. Medicare Diagnosis Changes

   Stella1688 replied to Stella1688's topic in Hospice

   Just curious, who decided on coding "senile degenerative brain" for dementia? Is there any documentation that this is a better coding choice than just regular dementia, or was it just a company decision? I appreciate your input

6. Medicare Diagnosis Changes

   Stella1688 replied to Stella1688's topic in Hospice

   NC29mom I am referring to the most recent updates from CMS and looking for help from those who have read them. I understand that comorbs should be listed, my question is a matter of the primary dx. I also do not work for a company that fraudently adm...

7. Medicare Diagnosis Changes

   Stella1688 replied to Stella1688's topic in Hospice

   Hi All, I have read and reread the Federal Register from CMS that was released 8/7/13 with the final rule on these diagnoses...and it is very vague for Dementia. On one hand it looks like they don't want us to use Dementia as a primary dx at all, and...

8. Hospice Resources

   Stella1688 replied to Carla25's topic in Hospice

   Join HPNA, they have a member's only educational section and try to attend a conference in the future. Purchase the core curriculum book from HPNA (it is what is used to study for the certification test). Your employer should have hospice education a...

9. Ripped into a million pieces

   Stella1688 replied to Vtachy1's topic in Hospice

   YES! It has taken a long time to learn not to take it personally. Like the others said we are entering someone's life at the most vulnerable time, but also the families most overwhelming time. It is a lot harder to be the caregiver watching your love...

10. Medicare Diagnosis Changes

    Stella1688 replied to Stella1688's topic in Hospice

    I agree Tewdles and Nurse_Diane! In a way I am not surprised about AFTT and debility since they have been talking about that for years (and I believe some agencies do overuse these dx and put people on hospice that aren't quite appropriate), but dem...

11. Medicare Diagnosis Changes

    Stella1688 posted a topic in Hospice

    Hi All, I got the following message from NAHC regarding proposed CMS changes: NAHC is reporting that in the CMS Open Door Forum held on May 8, CMS indicated thatin the future they will be returning claims to Hospice providers for certain diagnosis co...

12. Let's talk $$ for hospice. (Idea lifted from Agency nursing)

    Stella1688 replied to SuzieVN's topic in Hospice

    Oops I forgot to say I am an RN and mileage is 0.55, but we do have a high cost of living and gas prices

13. Let's talk $$ for hospice. (Idea lifted from Agency nursing)

    Stella1688 replied to SuzieVN's topic in Hospice

    I work full time in CT $35/hour, don't usually have to take on call but anything over 40 hours is time and a half

14. Is providing continuous home care required?

    Stella1688 replied to nurseebol's topic in Hospice

    I work for a small hospice agency that is only 1 year old and the majority of my patients have been in facilities or home with appropriate care so I have not yet needed to implement continuous care, however if there was truly a need we would implemen...

15. Going to Facilities

    Stella1688 replied to idobelieve's topic in Hospice

    Try to educate the nurses at the facility as much as you can and empower them to get involved in end of life care. For the most part I have found LTC nurses to be caring and receptive to education, but they are usually stressed and over worked. A few...