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In This Issue

MedPAC Stays on Track for Hospice Payment Reform
The Medicare Payment and Advisory Commission (MedPAC) met in early November 2009 to discuss, among other topics, hospice visit patterns. Even though the hospice visit patterns identified by MedPAC were somewhat limited due to available visit data, the data collected continues to support MedPAC’s previous recommendation to reform the hospice Medicare benefit (HMB) and adjust hospice payments based on the length of stay rather than the current flat per diem rate. more…

Visa Options for Hiring Foreign Nurses
The U.S. Department of Labor predicts a growing need for registered nurses due to an aging population and technological advances that emphasize preventive health care. In fact, according to the Bureau of Labor Statistics, health care is one of the two industry sectors expected to have the largest employment growth, adding four million jobs between 2008 and 2018. more…

Hospice Licensing Rules Amended for Respite Care
On December 17, 2009, the North Carolina Rules Review Commission approved an amendment to the Hospice Licensing Rules governing staffing requirements for hospice inpatient units to more closely align with the Medicare Hospice Conditions of Participation. Effective January 1, 2010, “the presence of a registered nurse (RN) to provide direct care on all shifts is not required for patients receiving respite care unless specific nursing needs are in an individual patient’s plan of care.” However, 24-hour patient care RN staff is required if a patient in the inpatient facility is receiving general inpatient care for symptom management. 10A NCAC 13K .1202

Wage and Hour Pitfalls for Hospice Employers
Employers in the hospice industry are frequently faced with wage and hour issues involving the Fair Labor Standards Act and North Carolina Wage and Hour Act, including provisions specifically pertaining to health care workers. Many of these issues can be confusing and troublesome. more…

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