Hospice & Palliative Care Handbook, Fourth Edition: Quality, Compliance, and Reimbursement


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The goal of the fourth edition of this book is to help hospice clinicians, team members, and managers meet numerous quality, coverage, and reimbursement standards and requirements for success in daily practice, operations, and documentation. All these components are needed to meet the coverage requirements of the Medicare Hospice Benefit and provide skillful and compassionate hospice care.

Part 1-Hospice Care: An Overview of Quality and Compassionate Care. This part provides the foundational information needed to understand hospice and hospice within the confines of the larger healthcare system. Simply put, hospice, a type of palliative care, is the model for quality, compassionate care for people facing a life-limiting illness or injury. This model and special care is explained in this opening part.

Part 2-Documentation: An Important Driver for Care and Coverage. This part focuses on the numerous and important roles that documentation plays in the provision of care as well as quality and reimbursement components related to hospice care. This part provides the fundamentals as well as why documentation is the key to care coverage, compliance, and quality for hospice patients and organizations.

Part 3-Planning, Managing, and Coordinating Hospice Care. Hospice care is individualized care provided by the interdisciplinary group for each patient and the patient's family. This part clearly explains hospice care planning and the ongoing process for success.

Part 4-Hospice Diagnoses and Guidelines for Care. Prior parts of this book address that the Medicare Hospice Benefit is prognosis-based, which means that the patient must have a limited life expectancy and the hospice is responsible for caring for and covering all costs for the terminal or primary diagnosis and all diagnoses that contribute to the terminal prognosis. In this part, the guidelines for care or care problems are specific topics or diagnoses that are organized alphabetically for easy identification and retrieval of needed information. This information can

then be individualized for your hospice patient/family and used throughout care and care planning as well as in the clinical record. This information can even serve as a basis for a common glossary in team meetings, discussions, and ongoing care planning communications. This part was formatted and designed for easy review for care and care planning and related activities. The hospice diagnoses or care guidelines are generally formatted in the same manner across all sections/diagnoses topics, as follows:

  • General Considerations
  • Eligibility Considerations
  • Potential Diagnoses ICD-10-CM Diagnostic Coding
  • Safety Considerations
  • Skills and Services Identified
  • Patient, Family, and Caregiver Educational Needs
  • Tips for Supporting Quality, Safety, Eligibility, and Reimbursement
  • Quality Metrics


  • Author: Tina Marrelli
    Publisher: SIGMA Theta Tau International
    Published: 06/15/2023
    Pages: 326
    Binding Type: Paperback
    Weight: 0.81lbs
    Size: 8.47h x 5.32w x 0.69d
    ISBN13: 9781646480852
    ISBN10: 1646480856
    BISAC Categories:
    - Medical | Nursing | Palliative Care
    - Medical | Emergency Medicine
    - Medical | Nursing Home Care

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