A friendly reader pointed out this article in the Daily Oklahoman newspaper about a hospice that is facing a huge cap issue.
Since it seems that most of the people interviewed for the article are from the hospice that has this large cap problem, it is a bit slanted to their point of view, but this does show the prominence that the cap issue is taking in the hospice world.
Here’s a question for the mathematically inclined readers:
If this hospice owes $2,000,000 dollars in over payments, and that amount is equal to 20% of the hospices total reimbursement for the year, then what is the approximate average length of stay for patients on the hospice?
Yes, I know the cap formula is much more complicated than this, but I think we could use the information from the article to figure out roughly what the ALOS for the hospice was. Generally, I think you can assume that the cap allows an ALOS of 180 days. I think that means that the hospice featured in the article could well have an ALOS of around 220 days. Check my math; Lord knows that is far from my strong suit! Once you check your math, let me know if you think that a hospice that follows the certification/recert guidelines would/should/could have an ALOS of 220.
Before I publish this, I know commentors are going to say that cap problems can come from ethical hospices admitting patients that have been discharged by unethical hospices at the end of their cap usefulness. . . I know that kind of junk could happen, but I do not believe any of it has led to the apparent epidemic of cap issues. This hospice does not claim that their cap problems come from anything except, “their patients not dying fast enough.”
While I’m at it, I’d also like to say that I find the accusation that Medicare is punishing a hospice because patients don’t die fast enough to be tasteless. Rhetoric like that doesn’t make me want to join the cap fight for sure!