Please remind us where we can find slides - Not finding them on NHPCO site, but probably looking in wrong place!

The recording and the slides will be posted within 24 hours after the presentation via NHPCO web link https://www.nhpco.org/regulatory-and-quality/quality/projectecho/project-echo-session-recordings/

Is Dr. Calabrese able to share their drug diversion protocol?

Was there a wife and an ex-wife involved?

We welcome any additional questions. Please feel free to type your questions into the chat box or raise your hand to be called on.

If I heard correctly, the patient was lethargic, not really responsive after the first couple of visits. Do you think he over-medicated himself or do you think the brother over- medicated him?

since the referring Dr was concerned about pain management and constant request for narcotics. Did the hospice dr ever consider using methadone right away?

Did your admission process change after this experience? If so, how?

We had a discharge for cause 10/29/21. Is there a time frame to notify the state agency when we discharge for cause?

Do you feel if waiting for POA paperwork it will delay much needed admissions?

Was any his issues with narcotics documented in his medical that you received prior to his admission?

Do you use an opioid risk assessment tool as part of your assessment for all your admissions?

Discharge for cause: There may be extraordinary circumstances in which ahospice would be unable to continue to provide hospice care to a patient. Thesesituations would include issues where patient safety or hospice staff safety iscompromised. When a hospice determines, under a policy set by the hospice forthe purpose of addressing discharge for cause, that the patient's (or other personsin the patient's home) behavior is disruptive, abusive, or uncooperative to theextent that delivery of care to the patient or the ability of the hospice to operateeffectively is seriously impaired, the hospice can consider discharge for cause.The hospice must do the following before it seeks to discharge a patient for cause:o Advise the patient that a discharge for cause is being considered;o Make a serious effort to resolve the problem(s) presented by the patient'sbehavior or situation;o Ascertain that the patient's proposed discharge is not due to the patient'suse of necessary hospice services; ando Document th

20.2.3 - Hospice Discharge(Rev. 209, Issued: 05-08-15, Effective: 10-01-14, Implementation: 05-04-15)

Medicare Benefit Policy Manual gives additional details on DC for cause https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c09.pdf

Thank you for sharing this situation and your steps taken. Very good information from you and our experts.

Thank you all for participating. The recording and the slide will be available at https://www.nhpco.org/regulatory-and-quality/quality/projectecho/project-echo-session-recordings/ in 24-48 hrs