Hospices have been implementing various approaches to cope with the increased regulatory scrutiny in the past 3 years, prompted by concern about costs and outcomes. Medicare, through its fiscal intermediaries, has issued increasingly more restrictive local coverage determination guidelines for initial and ongoing qualifying criteria. The article examines how one hospice, United Hospice of Rockland, Inc. (UHR, New City, NY), designed multifaceted program to simultaneously improve regulatory compliance and improve quality of life. This article presents how the six scales (i.e., pain-verbal and non-verbal, breathing, functional decline-PPS and Fast, and anxiety) were developed and implemented, and also presents the preliminary evaluation of successful results.
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