End-of-Life Care

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Inpatient mortalities are tracked and publicly reported by CMS.

Palliative care is specialty medical care for people living with a serious illness that focuses on quality of life for the patient and their family. The goal of palliative care is to relieve symptoms associated with serious illness e.g., pain, difficulty breathing, nausea, etc.

Palliative care:

  • Can be provided with curative treatments
  • Is known as “comfort care”
  • Does not require a do-not-resuscitate (DNR) order

In contrast, hospice services include palliative care for those patients within six months of the end of their life when all efforts to treat the terminal illness are suspended.

  • Hospice care is not usually provided in a short-term care facility, e.g., inpatient hospital
  • Medicare will either cover hospice care or an inpatient admission to a short-term acute care facility for the terminal diagnosis

Patients enrolled in a Medicare hospice program prior to admission or within the first day of admission are exempt from reporting in CMS mortality metrics.

  • Terms such as comfort care, DNR/DNI and poor prognosis DO NOT qualify for this exemption (but may risk adjust).
  • Statements and/or orders, such as will consult palliative care or will consult hospice, DO NOT qualify for this exemption.

Although palliative care patients may have a lower intensity of service, your documentation should continue to reflect their complexity by reflecting all relevant diagnoses.

Download the complete tip, End-of-Life Care.