Announcements

CMS Changes Hospice Codes

The Centers for Medicare & Medicaid Services (CMS) announced new hospice site of service codes effective for claims with dates of service on or after October 1, 2010. Hospice providers should use the HCPCS Q5010 code for reimbursement for Routine Home Care or Continuous Home Care provided at a hospice residential facility or a hospice facility that is also certified to provide inpatient care. Hospices are directed to use Q5003 for patients receiving care in an unskilled nursing facility. Providers should use Q5004 for reimbursement for care provided in a skilled nursing facility. If a facility offers both skilled and unskilled care, the hospice must determine the level of care the patient receives and code accordingly. More information is available at: www.pinnaclemedicare.com/cptagreement/default.aspx?linkdest=%2fprovider%2fviewarticle.aspx?articleid=8717.

National Palliative Care Registry™

The National Palliative Care Registry™—the only repository for national data on the structures and processes of hospital palliative care programs. The Registry was created to help develop operational standards and demonstrate the reach and impact of the field. https://registry.capc.org/Default.aspx.

Registering your program is an annual process. Each year when you register your palliative care program, you'll be able to:

Receive a premium listing in the www.getpalliativecare.org Provider Directory of Hospitals for 1 year. Your listing will be highlighted and will have more complete information than a regular listing.

HPNA Announces Inaugural Class of Research Scholars

The Hospice and Palliative Nurses Association (HPNA) and its Board of Directors have announced that five current members of the national organization have been selected as the inaugural class of HPNA Research Scholars. The 2010 Research Scholars are as follows:

Abraham Brody, RN, PhD, GNP-BC

The HPNA Research Scholars Program supports funding to participate in the 4th Annual Kathleen Foley Palliative Care Retreat and Research Symposium of the National Palliative Care Research Center (NPCRC), cosponsored by American Academy of Hospice and Palliative Medicine (AAHPM), American Cancer Society (ACS), and HPNA. The retreat was held October 12–14, 2010 in Sundance, Utah. Also participating in the retreat are the recipients of National Palliative Care Research Center Pilot/Exploratory Grants and Career Development Awards and recipients of American Cancer Society Palliative Care Pilot/Exploratory Grant Awards.

The goal of the retreat is to advance the scientific endeavors of those who are or will become independent investigators actively involved in palliative care research through development of attendees' individual works in progress and improvement of specific competencies and core methodologies essential to conducting palliative care research. The meeting format will include didactic lectures, small group discussion by topic area and/or discipline, mock study sections, poster presentations, and networking opportunities. Recipients of this distinguished HPNA award will be expected to be present for the entire retreat and complete progress updates at 6 months and 12 months following the retreat.

NHPCO Issues Statement about Palliative Sedation Therapy

The National Hospice and Palliative Care Organization issued a statement clarifying the groups' position about palliative sedation therapy. NHPCO said that health care providers, patients, and families should consider the treatment option for a very limited number of imminently dying patients whose pain is intolerable and unresponsive to other palliative interventions. Sedation should be titrated to reduce consciousness to the minimum level necessary to render symptoms tolerable. A physician with expertise in palliative care must lead the intervention. NHPCO said that “palliative sedation is categorically distinct from euthanasia and assisted suicide.” Further information: www.nhpco.org/i4a/pages/index.cfm?pageid=5847.

CMS to Test Allowing Concurrent Care for Children

Health care reform includes a provision that instructs Children's Health Insurance Programs and Medicaid plans to begin covering curative and hospice care for children with terminal illnesses. In addition, the Department of Health and Human Services will conduct a Medicare demonstration project of concurrent care for Medicare patients to assess whether it helps patients and saves federal dollars. Depending on the results of the three-year study, Congress could change the hospice-care benefit. Further information is available at American Medical News: www.ama-assn.org/amednews/2010/05/24/prsb0524.htm.

FDA Changes Tramadol Labeling

The U.S. Food and Drug Administration has changed the language in the warning section of the prescribing information for tramadol, a synthetic opioid analgesic, to emphasize the risk of suicide in addiction-prone patients or those also taking tranquilizers or antidepressant drugs. The changes also warn about the risk of overdose, potentially resulting in central nervous system depression, respiratory depression, and death. Tramadol used in conjunction with alcohol, other opioids, or illicit drugs causing central nervous system (CNS) depression may be expected to have additive effects. Tramadol-related deaths have occurred in patients with previous histories of emotional disturbances or suicidal ideation or attempts, as well as histories of misuse of tranquilizers, alcohol, and other CNS-active drugs. FDA website link: www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm213264.htm.

CAPC Palliative Care Leadership Centers: Intensive Training and Year-Long Mentoring

Palliative Care Leadership Centers (PCLC) are leading palliative care programs that provide customized, hands-on operational training—and yearlong mentoring—for palliative care programs at every stage of development and growth. The PCLCs represent diverse settings including health systems, community-based hospitals, hospices, academic medical centers, cancer centers, children's hospitals, VA, and safety-net hospitals. Each offers a close, hands-on experience, as well as a 12-month mentoring follow-up to guide you through the challenges of program growth and sustainability. PCLC faculty are physician and nurse leaders in the field and experts in applying the most effective palliative care program models. You will benefit from their deep experience, knowledge, and mentoring in all matters of program development. There is a type of PCLC training to address the specific needs of each and every program—whether you are starting a program (PCLC Core), a pediatric palliative care program, or an active program up and running for at least 1 year (PCLC Custom and PCLC Consult).

For training sites and dates and to learn more: www.capc.org.

AAHPM Accepting Applications: Clinical Scholars Program

The AAHPM is now accepting applications from physicians for this 1-week observership program at select hospice and palliative medicine (HPM) sites across the United States. The program is designed to provide a focused clinical experience in hospice and palliative medicine to physicians. For more information please visit www.aahpm.org/education/clinicaltraining.html.

Clinical Fellowships Available

The Center for Palliative Studies at San Diego Hospice & Palliative Care offers 10 one-year clinical fellowships leading to eligibility for certification by the American Board of Hospice and Palliative Medicine, beginning July 1 each year. Two second-year research positions are available for physicians preparing for an academic career. Preferred candidates will BE or BC by an ABMS-recognized board. Combined training in Geriatrics, Hematology Oncology is possible. For more information, please contact Charles F. von Gunten, MD, PhD, at cvongunten@sdhospice.org or 619-278-6225. San Diego Hospice & Palliative Care is a teaching and research affiliate of the University of California, San Diego School of Medicine.