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Type:
Value Sets
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Resolution: Unresolved
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Priority:
Moderate
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None
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Encounters for Hospice are being captured.
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Kim Crady
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9043213735
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Baptist Health
Hello JIRA,
Hospice / Palliative Care.
Patients Who are admitted to hospice in our acute care hospital usually do not get Labs / Vital Signs. This places them in the denominator.
Most of these patients have two separate encounters – one for the initial encounter, and one for the hospice encounter. In the instances impacted – these patients do not get transferred to another floor or bed. Only their billing is changed.
The Specs do not address this. This is being counted as a readmission.
If the patient expires in the hospital - it is captured in the mortality.
The specs:
Inpatient Encounters
from
["Encounter, Performed": "Encounter Inpatient"] InpatientEncounter,
["Patient Characteristic Payer": "Medicare payer"] Payer,
["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."HospitalizationWithObservationLengthofStay" ( InpatientEncounter ) < 365
and InpatientEncounter.relevantPeriod ends during day of "Measurement Period"
and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of InpatientEncounter.relevantPeriod ) >= 65
return InpatientEncounter
There are no exclusion or exceptions in the specs.
Example patient: (readmission and Mortality)
(For the second encounter)
Final Principle Dx is “Encounter for Palliative care”.
With their Primary insurance as:
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- HOSPICE OF NORTHEAST FLORIDA/ *********** HOSPICE OF NORTHEAST FLORIDA
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And a secondary insurance of Medicare.
This impacts a number of patients.
Will this be considered in future updates?
Thanks,
Kim