Deck 13: Hospice

Question 1

The _________________________ provides care to the hospice patient in the patient's place of residence (such as giving medications, dressing changes, reporting changes in patient's condition) when hospice staff are not there.

A) bereavement counselor
B) primary caregiver
C) gatekeeper
D) volunteer

Answer 1

primary caregiver

Question 2

Mr. Jones has elected the hospice benefit. Upon election of the hospice benefit, Mr. Jones _________________________.

A) waives standard Medicare coverage for services related to the terminal diagnosis
B) can continue to receive all other services covered under standard Medicare benefits
C) can continue to receive other Medicare benefits except for inpatient hospitalization
D) agrees to pay all out-of-pocket hospice expenses should his hospice stay extend beyond the third benefit period

Answer 2

waives standard Medicare coverage for services related to the terminal diagnosis

Question 3

A hospice patient is admitted to a hospital for pain and symptom management. The hospice will be reimbursed for _________________.

A) routine home care
B) inpatient respite
C) general inpatient care
D) continuous care

Answer 3

general inpatient care

Question 4

In a hospice situation, the _______________ period ordinarily lasts about one year.

A) bereavement
B) respite care
C) terminal illness
D) active phase of dying

Question 5

Clinical measures taken to reduce the intensity of disease symptoms, rather than providing a cure for the disease are called _______________.

A) respite care
B) assessment
C) curative therapy
D) palliative care

Question 6

Which of the following statements is true concerning Medicare regulations regarding volunteers in hospice?

A) Volunteers may provide clerical or administrative assistance, but no other hospice services.
B) Volunteers are prohibited from making entries in the patient's clinical record.
C) Volunteer hours must equal at least 5% of the patient care hours of paid employees and contract staff.
D) Volunteers must be licensed or certified health care professionals, for example, RN, PT, OT, RT, RHIA, or RHIT.

Question 7

Hospice care focuses on the needs of _____________________.

A) the patient only
B) both the patient and the family
C) the patient, the family, and the hospice staff
D) the patient, the family, the hospice staff, and volunteers

Question 8

__________________ deals with the number of admissions, discharges, transfers and number of patients under the care of a hospice on a given day.

A) reimbursement data
B) resource data
C) patient data
D) census data

Question 9

Where is the majority of hospice care provided?

A) hospital
B) skilled nursing facility
C) patient's place of residence
D) acute inpatient hospice facility

Question 10

An individual is considered to be terminally ill if he or she has a life expectancy of _____________ or less based on the physician's clinical judgment regarding the normal course of the individual's illness.

A) 3 months
B) 6 months
C) 12 months
D) 24 months

Question 11

The National Hospice and Palliative Care Organization (NHPCO) __________________.

A) has a survey process similar to other regulating and accrediting agencies
B) publishes a book of standards that must be used by hospices to achieve deemed status.
C) has staff available to answer questions or concerns regarding interpretation of NHPCO standards
D) requires hospices to be certified or accredited

Question 12

When a Medicare patient revokes the election of hospice care, ____________________.

A) the patient returns to standard Medicare coverage
B) the patient must be certified as no longer terminally ill
C) hospice services are reimbursed under Medicare Part B
D) the patient cannot elect hospice benefits again in the future

Question 13

The Palliative Performance Scale _____________________________.

A) electronically tracks census data
B) titrates medications for pain relief
C) rates the effectiveness of hospice services
D) assesses the patient's physical, functional, and mental status

Question 14

In hospice, coding additional ___________________________ helps build a diagnosis database that can be used to evaluate not only the quality of care given, but also the components of various diagnosis groups.

A) HHRGs
B) procedures
C) signs and symptoms
D) major diagnostic categories

Question 15

When coding, which would be more useful to hospice staff for internal evaluation of the quality of care provided to the terminally ill?

A) lung cancer of the upper lobe
B) acute myocardial infarction
C) cerebrovascular accident
D) urinary tract infection

Question 16

The days of care reimbursed by Medicare at an inpatient rate (either general inpatient or respite) __________________________.

A) must be at least 20% of the total days of hospice care
B) can be no more than 20% of the total days of hospice care
C) are the only categories of hospice care paid retroactively for services provided before the patient elected the hospice benefit
D) are excluded from payments under the hospice benefit and paid directly to the inpatient facility at the PPS rate for the type of facility where the care is rendered

Question 17

Upon the death of the patient, the health information department may get numerous requests from insurance companies or attorneys to settle a claim or probate the patient's estate. No information should be released without proper authorization from ___________________.

A) the next of kin
B) a bereavement counselor
C) the hospice medical director
D) the legal representative of the estate

Question 18

Hospices routinely provide __________________ services as part of the hospice benefit.

A) radiology
B) transfusion
C) social work
D) chemotherapy

Question 19

Under Medicare, hospice payment rates are adjusted based on ______________________

A) the patient's age
B) care area triggers
C) the geographic location of the patient
D) the patient's diagnoses and procedures

Question 20

Medicare reimburses hospice care on a ____________________ basis.

A) cost
B) per diem
C) capitation
D) prospective

Question 21

Hospice care focuses exclusively on the needs of the patient as the unit of care.

Question 22

Under Medicare regulations, both the attending physician and the hospice medical director must certify that the patient is terminally ill.

Question 23

Hospices provide curative therapy rather than symptom management.

Question 24

No more than 50% of hospice care can be provided in the patient's place of residence.

Question 25

The primary caregiver is the person designated to provide care for the hospice patient when hospice staff is not available.

Question 26

When a hospice patient is admitted to the hospital for pain and symptom management, the hospital is reimbursed by Medicare for the DRG and the hospice receives a reduced per diem payment for each day of the patient's stay.

Question 27

The Affordable Care Act requires that a hospice physician or nurse practitioner have a face-to-face encounter with a hospice patient not more than 15 days prior to the start of the hospice patient's second benefit period .

Question 28

Volunteers may be paid at a lower hourly rate than other hospice employees.

Question 29

Medicare regulations permit certification of terminal illness with a life expectancy that is unknown and/or unspecified.

Question 30

A hospice program is licensed by the state in which it is located.

Question 31

There is no voluntary accreditation organization with deeming authority for hospice programs and facilities.

Question 32

In addition to clinical staff, the hospice interdisciplinary group includes a pastoral or other counselor who offers spiritual support and comfort.

Question 33

Hospice benefit periods are categorized as an initial 60-day period, a subsequent 60-day period, then a final 90-day period.

Question 34

By definition, the patient's primary caregiver is also the patient's legal representative.

Question 35

Hospice services require little out-of-pocket expense and paperwork on the part of the patient and/or family.

Question 36

Hospice and home care tend to be high-pressure, high-burnout working environments for clinical staff, with staff turnover high in some areas

Question 37

Many hospice patients are unable to consent for themselves and have appointed personal representatives.

Question 38

The time period beginning immediately upon the death of the patient and lasting up to one year or longer is the period of _____________________.​

Question 39

______________________________ is any medical therapy given for the purpose of curing disease.​

Question 40

A(n) _____________________________ is a facility or a program designed to provide a caring environment to meet the physical and emotional needs of terminally ill patients and their families and significant others.​

Question 41

A(n) ________________________________ is a specific set of beds, either in a hospice building or as a wing of a hospital or nursing home, providing round-the-clock clinical staff to care for terminally ill patients.​

Question 42

The _________________________________ group is made up of two or more clinical disciplines-usually a nurse, social worker, hospice aide, physician, pastoral or other counselor, volunteer, therapist, and dietitian- who plan for the care of the terminally ill patient.​

Question 43

__________________________________ consists of clinical measures taken to reduce the intensity of disease symptoms, rather than providing a cure for the disease.​

Question 44

The ______________________________ is wherever the patient is currently living-his or her own home, a relative's home, a senior citizen's complex, a nursing home, assisted living, etc.​

Question 45

The ______________________________ is the person designated to provide care for the patient when hospice staff is not available.​

Question 46

When a patient takes action to ________________ the hospice benefit, the patient returns to standard Medicare or other commercial insurance benefits and loses all remaining days in the current benefit period.​

Question 47

Under hospice regulations, a patient is classified as ____________________ based on physician judgment that the patient has a limited life expectancy of six months or less.​

Question 48

A(n) ______________________________ is a person who provides a service (clerical, clinical, companionship, etc.) without any monetary or other reimbursement.
​

Question 49

Match each description with the correct item

- A patient is at his or her place of residence and is receiving non-problematic care.

A) continuous care
B) general inpatient care
C) respite care
D) routine home care

Question 50

Match each description with the correct item

- A patient receives predominantly nursing care for a minimum of eight out of 24 hours at his or her place of residence during a period of crisis.

A) continuous care
B) general inpatient care
C) respite care
D) routine home care

Question 51

Match each description with the correct item

- A patient receives care in an approved facility on a short-term basis (not more than five days at a time).

A) continuous care
B) general inpatient care
C) respite care
D) routine home care

Question 52

Match each description with the correct item

- A patient receives care in an approved facility for pain control or acute or chronic symptom management.

A) continuous care
B) general inpatient care
C) respite care
D) routine home care

Question 53

Which specialties should be included in the interdisciplinary group according to the National Hospice and Palliative Care Organization??

Question 54

List three items that the plan of care must include per Medicare Conditions of Participation.?

Question 55

​Describe three items that a hospice medical record should document.

Question 56

Describe respite care and associated procedures and regulations as related to the hospice setting.​

Question 57

Discuss two trends that hospice will be challenged by in the future.?