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1980
P
H
N
2015
35th Anniversary
Celebrating the Future
of Hospice
and
Palliative Care
Annual Conference
April 19-21, 2015
Welcome
Dear Hospice and Palliative Care Friends and Colleagues,
Pennsylvania Hospice Network
Promoting Excellence in End-of-Life Care
Lonna H. Donaghue, MGA
Executive Director
Pennsylvania Hospice Network
Susan M. Metz, AAS
Coordinator of Educational Programs &
Membership Services
Pennsylvania Hospice Network
Cynthia Campbell-Samuels,
RN, BSN
Orthopedic Care Manager
Lebanon VA Medical Center
Rev. Anne G. Huey,
MDiv, MSHS, BCC
Spiritual Services Manager
St. Luke’s Hospice
Rev. Jim Ingalls, BA, MA Mis
Chaplain
VNA Hospice of Philadelphia
Paige E. Payne, MS, MSW,
LSW, ACHP-SW
Director of York Hospice
Hospice & Community Care
Celebrating
the Future
of Hospice
and Palliative Care
2
I am honored to be representing the
Board of Directors of the Pennsylvania
Hospice Network, and particularly
honored to welcome you to our annual
conference AND 35th Anniversary:
Celebrating the Future of Hospice and
Palliative Care.
Once again, the Education
Subcommittee and the Board have put
together an exciting, diverse and comprehensive set of
topics and speakers. We begin with a pre-conference
Workshop that brings an inter-disciplinary Team approach
to challenging situations which should stimulate thought,
discussion and collaboration. Our Keynote speaker, Dr.
Janet Bull, is the Chief Medical Officer of Four Seasons
Compassion for Life. She is a national leader in hospice
and palliative care and the winner of multiple prestigious
awards: the Sharon O. Dixon Award in 2007, the CuniffDixon Hastings Award in 2012, the Josephino Magno
Distinguished Physician Award in 2013 and she was
named as one of the Top 30 Visionaries in the field. We
are honored to have her share her vision for the future of
our field. The conference closes with a return visit by Dr.
David Casarett to discuss his book “Shocked: Adventures
in bringing back the Recently Dead”. In between, we have
a truly wonderful selection of speakers and topics that will
engage, inform and energize you. There is a dedicated
track focusing on and highlighting our Veteran population,
which, as a former Navy Physician I am very proud of.
Dame Cicely Saunders helped define what hospice should
be. She is the role model for physician involvement and
leadership in Hospice and Palliative Care. This years’
conference highlights and celebrates her impact with a
magnificent physician contribution and participation.
Come, join in the Celebration of 35 years of working
to improve Hospice Care in Pennsylvania. Celebrate our
Past, engage in our Present and Join with us to move into
our Future of providing high quality Hospice and Palliative
Care throughout Pennsylvania.
Find me and Say Hello,
Ric
Ric Baxter, MD, FAAHPM
President, PHN Board of Directors
Conference Agenda
Sunday, April 19
12:00 noon – 4:30 pm
1:00 pm – 5:00 pm
6:00 pm – 7:30 pm
Registration
Pre-Conference Workshop – Advancing the Interdisciplinary Team Approach in Working with Challenging
Situations - Ric Baxter, MD, FAAHPM; Jane Feinman, MSN, RN; Rev. Anne Huey, MDiv, MSHS, BCC;
Paige Payne, MS, MSW, LSW, ACHP-SW
Opening Reception: Dinner Buffet/Exhibitors
Monday, April 20
Registration
Exhibit Hall Open
Breakfast with Exhibitors
Keynote – Navigating the White Water Rapids – The Future of Hospice & Palliative Care –
Janet Bull, MD, FAAHPM
am – 9:45 am
Break with Exhibitors
am – 11:15 am
Session 1
1-A “Relatedness”: Decision-making and Documentation – Joan K. Harrold, MD, MPH, FACP, FAAHPM;
Jennifer L. Kennedy, MA, BSN, CHC
1-B Pain Management and Opioid Prescribing Geared Toward Hospice and End-of-Life Focus –
Deborah Way, MD, CMD, FAAHPM
1-C Developing Best Practices in Billing and Coding for Providers in Hospice and Palliative Care –
Janet Bull, MD, FAAHPM
1-D We Honor Veterans: Can We Bring Together a Community of Care for Veterans at End of Life? –
Scott T. Shreve, DO
1-E No Dress Rehearsal: Knowledge Helps The Dying Journey – Judy Dobson, MSN, CHPN
11:30 am – 1:00 pm
Session 2
2-A Regulatory Update for Hospice Providers – Jennifer L. Kennedy, MA, BSN, CHC
2-B Oncologic Emergencies and Advanced Symptom Management of Cancer Patients –
Lorin Yolch, PharmD, CGP, FASCP
2-C Integrating Massage Therapy into the Hospice Patient’s Plan of Care – Ellen M. Liberto, BS, LPN, LMT, CHPLN
2-D Resting the Soul: Veterans and Spirituality – Paul F. Tschudi, EdS, MA, BA
1:00 pm – 2:15 pm
Awards Lunch
2:15 pm – 2:45 pm
Break with Exhibitors
2:45 pm – 4:15 pm
Session 3
3-A How to Achieve and Sustain Stellar Clinical Documentation – Kathy Baker, MSN, RN; Christine Smith, CSSGB
3-B Preventing Caregiver Moral Distress Associated With End-of-Life Patients Dependent on Mechanical Respiratory
Devices – Brenda Carroll, RN, MSN, CMSRN; Lorraine Dickey, MD; Albert Voorhis, MDiv; Christina Kulp, MSW;
Lisa Bickel, RN; Lori Ann Fontaine, RN
3-C Holy Cow, What Do We Do Now: Transitioning Pediatric Patients Directly From the Intensive Care Unit to the
Home Setting With Hospice Services – Gwenn LaRagione, RN, BSN, CCM, CHPPN;
Shefali Parikh, MD; Wynne Morrison, MD, MBE; Julie Hertz, BSN, RN
3-D No Veterans Die Alone – Cynthia Campbell-Samuels, BSN, CRRN, CHPN; Tracey Wheatley RN, CHPN
7:00
7:00
7:00
8:00
9:15
9:45
am
am
am
am
–
–
–
–
4:30 pm
3:00 pm
8:00 am
9:15 am
Tuesday, April 21
7:00
7:00
7:00
8:00
am
am
am
am
–
–
–
–
11:30 am
11:30 am
8:00 am
9:30 am
9:30 am – 10:00 am
10:00 am – 11:30 am
11:30 am – 1:00 pm
Registration
Exhibit Hall Open
Breakfast with Exhibitors
Session 4
4-A Staying Compliant With the Hospice Regulations and What New Regulations Can Hospice Expect –
Judy L. Connelly, RN, MSN; Deborah J. Kelly, DNP, RN, CHPN, Lynn O’Brien, RN, MSN, CHPCA;
Susan Smith, MSN, CHPN
4-B Recognizing, Assessing and Managing Difficult Pain Syndromes in Advanced Illness: Bang Head Here –
Mary Lynn McPherson, PharmD, BCPS, CPE
4-C But Grandma Has Always Been On Blood Thinners and Cholesterol Medicine! –
Stanley J. Savinese, DO, FAAHPM, HMDC
4-D I Can’t Fix This with a Pill!: Identifying and Addressing Existential Suffering – Ric Baxter, MD, FAAHPM;
Rev. Anne Huey, MDiv, MSHS, BCC; Rev. Jim Ingalls, BA, MA Mis
Break with Exhibitors
Session 5
5-A Pennsylvania Department of Health Update for Hospice Programs – Linda Chamberlain, MS, BSN, RN
5-B Providing End of Life Care Between a Rock and a Hard Place: Managing Patients With A History
of Substance Abuse – Mary Lynn McPherson, PharmD, BCPS, CPE
5-C Palliative Pearls in Caring for Older Adults – Amy Corcoran, MD, CMD, FAAHPM
5-D “Once Again, What About Me?” Addressing the Needs of Grieving Children and Adolescents –
Brian Medkeff-Rose, MDiv, MA
Closing Luncheon – Shocked: Adventures in Bringing Back the Recently Dead – David Casarett, MD, MA
3
Special Events
Sunday, April 19, 2015
Monday, April 20, 2015
Opening Reception:
Dinner Buffet/Exhibitors
6:00 pm – 7:30 pm
Awards Luncheon
1:00 pm − 2:15 pm
Relax with friends, new and old, and network with hospice
colleagues while enjoying a delicious buffet and cash bar.
Visit with the exhibitors and learn about the new products
and services they have to offer.
PHN will honor individuals selected for their dedication to
the care of the terminally ill and their promotion of hospice.
The nomination categories are:
•
•
•
•
•
The Nancy Bohnet Award for Excellence
Community Support
Heart of Hospice
Journalism
Spirit of Hospice
Featured Speakers
Sunday, April 19, 2015
Pre-Conference Workshop
Advancing the Interdisciplinary Team
Approach in Working with Challenging
Situations
Ric Baxter
Jane Feinman
Rev. Anne Huey
Ric Baxter, MD, FAAHPM, Director
of Palliative Care Services, St.
Luke’s University Health Network;
Jane Feinman, MSN, RN, Executive
VP of Hospice & Palliative Care,
VNA Hospice of Philadelphia;
Paige Payne
4
Rev. Anne Huey, MDiv, MSHS, BCC, Spiritual
Services Manager, St. Luke’s Hospice;
Paige Payne, MS, MSW, LSW, ACHP-SW, Director of
York Hospice, Hospice & Community Care
Complex cases create unprecedented challenges for the
patient, families and the hospice team demanding a higher
level of interventions. Knowing there is “no magic wand”,
the team must develop a critical skills set to deliver quality end-of-life care when stressors such as drug diversion,
alcoholism, mental health issues and violence are present.
A panel discussion will present case studies through a team
approach to demonstrate how hospice providers effectively
managed challenging cases and ensured staff safety.
Learning Objectives: Identify best practices in navigating complex situations by exploring best strategies and
tools utilized by other providers through case studies.
Maximize the team effectiveness through collaboration of
each team members’ disciplinary skill set.
“Each year both the plenary and workshop
speakers are exceptional and I gain new ideas
and skills. The conference is a great addition
and support to what hospice providers are doing
every day.”
Featured Speakers
Monday, April 20, 2015
TUESday, April 21, 2015
KEYNOTE SPEAKER
Closing Luncheon
Navigating the White Water Rapids –
The Future of Hospice & Palliative Care
Shocked: Adventures in Bringing Back
the Recently Dead
Janet Bull, MD, FAAHPM
Chief Medical Officer
Four Seasons Compassion For Life
In this presentation, we will describe
changes in healthcare from a cost/
quality vantage point, learn three
attributes a hospice agency can
implement to prepare for the “white
water rapids” of the future, understand
the value proposition of palliative care, and discuss effect
on long term care facilities and opportunities to partner.
Learning Objectives: Describe the changes in
healthcare from a cost/quality vantage point. Identify
three attributes a hospice agency can implement to prepare
for the “white water rapids” of the future. Understand the
value proposition of palliative care and the effect on long
term care facilities and opportunities to partner.
David Casarett, MD, MA, Director
Hospice and Palliative Care
Penn Medicine
Professor of Medicine
Perelman School of Medicine
University of Pennsylvania
Not too long ago, there was no
coming back from death. But now,
with revolutionary medical advances, death has become
just another serious complication. As a young medical
student, Dr. David Casarett was inspired by the story of a
two-year-old girl named Michelle Funk. Michelle fell into
a creek and was underwater for over an hour. When she
was found she wasn’t breathing, and her pupils were fixed
and dilated. That drowning should have been fatal. But
after three hours of persistent work, a team of doctors and
nurses was able to bring her back. It was a miracle. If
Michelle could come back after three hours of being dead,
what about twelve hours? Or twenty-four? What would
it take to revive someone who had been frozen for one
thousand years? And what does blurring the line between
“life” and “death” mean for society? In his book Shocked,
Dr. Casarett chronicles his exploration of the cutting edge
of resuscitation and reveals just how far science has
come. He begins in the eighteenth century, when early
attempts at resuscitation involved public displays of barrel
rolling, horseback riding (sort of), and blowing smoke
up the patient’s various orifices. He then takes us inside
a sophisticated cryonics facility in the Arizona desert, a
darkroom full of hibernating lemurs in North Carolina,
and a laboratory that puts mice into a state of suspended
animation. The result is a spectacular tour of the bizarre
world of doctors, engineers, animal biologists, and
cryogenics enthusiasts trying to bring the recently dead
back to life. Fascinating, thought-provoking, and (believe it
or not) funny!
Learning Objectives: Understand the history of CPR.
Appreciate recent advances in resuscitation. Identify
potential future advances in resuscitation science.
5
Educational Workshop Schedule
Monday, April 20, 2015
SESSION 1 − 9:45 AM–11:15 AM
1A
“Relatedness”: Decision-making
and Documentation
Joan K. Harrold, MD, MPH, FACP, FAAHPM, Medical Director,
Vice President, Medical Services, Hospice & Community Care
and Jennifer L. Kennedy, MA, BSN, CHC, Regulatory and
Compliance Director, National Hospice and Palliative Care
Organization
CMS expectations and guidance for determining relatedness—and
responsibility for medication coverage—has been evolving. The
changes required over the past year require increased deliberation
and specific documentation from the hospice medical director
and staff. Attendees will use the Conditions of Participation, CMS
guidance, principles of “Choosing Wisely,” and the NHPCO
“Determining Relatedness to the Terminal Prognosis Process Flow” to
make determinations that comply with regulations and foster good
clinical care.
Learning Objectives: Discuss CMS’ expectations for hospices to
determine appropriate medication usage and coverage. Describe
medical “relatedness” as it applies to the hospice diagnosis and the
terminal condition. Delineate guidelines for documentation that meets
regulatory requirements.
1B
Pain Management for the Geriatric
Patient
Deborah Way, MD, CMD, FAAHPM, Director, Palliative Care
Services, Philadelphia Veterans Affairs Medical Center
This didactic and case based session will provide a review of pain
management focusing on the unique needs of the geriatric patient and
how this affects care at the end of life.
Learning Objectives: Identify and discuss causes of pain in the
geriatric hospice patient population. Formulate a plan of care for
pain relief in the geriatric patient. Define pharmacologic and non
pharmacologic treatments for pain.
1C
Developing Best Practices in
Billing and Coding for Providers
in Hospice and Palliative Care
Janet Bull, MD, FAAHPM, Chief Medical Officer,
Four Seasons Compassion For Life
In this presentation, we will equip the learner with best practices
regarding billing and coding. We will discuss the triggers for audits,
6
the difference between billing under complexity versus time, the use
of prolonged service codes, and nuances related to hospice and
palliative care. We will discuss some of the common pitfalls that occur
and discuss why it’s importance to have a compliance program. Nurse
practitioner and physician assistant billing will also be covered, as
well as the nuances related to our field.
Learning Objectives: Explain what triggers a billing audit. Discuss
differences between billing by time versus complexity. Understand the
basics of billing and coding and identify common pitfalls. Describe
transitional care coding. Discuss the importance of having a
compliance program.
1D
We Honor Veterans: Can We Bring
Together a Community of Care for
Veterans at End of Life?
Scott T. Shreve, DO, National Director, Hospice and Palliative
Care, Veterans Administration
This presentation will highlight the urgency of building a connected
community of care for Veterans at end of life and their families.
Through a combination of storytelling and evidenced based medicine,
this presentation will build on the learners’ expertise in understanding
military culture, the impact and approach to treatment of Post
Traumatic Stress Disorder at end of life and key organizational
initiatives for establishing a community of care for Veterans at end of
life.
Learning Objectives: Demonstrate the importance of the
demographic imperative for specialized expertise in honoring and
caring for Veterans at end of life. Develop at least two organizational
action items to address the care needs of Veterans at end of life.
1E
No Dress Rehearsal: Knowledge
Helps the Dying Journey
Judith A. Dobson, MSN, CHPN, Self-employed Hospice and
Palliative Care Educator
This workshop presentation will review the current efforts to improve
end-of-life care as cited by the Institute of Medicine’s recent report,
the Choosing Wisely principles, and the National consensus project’s
eight domains of palliative care. We will discuss symptom physiology
and management during the dying process, support of the family,
communication and instructions to family and caregivers, and
complications that may cause distress to the patient and others present.
Learning Objectives: Explain the symptoms observed during
phases of the dying process. Discuss three ethical issues that may
arise during the dying process. State the existential needs of the
dying.
Educational Workshop Schedule
Monday, April 20, 2015
SESSION 2 − 11:30 AM–1:00 PM
2A
Regulatory Update for Hospice
Providers
Jennifer L. Kennedy, MA, BSN, CHC, Regulatory and
Compliance Director, National Hospice and Palliative Care
Organization
Change happens! Is your organization on top of all the recent
regulatory changes affecting the hospice industry? This session will
highlight the important regulatory issues facing hospice providers
today. Participants will receive cutting edge information about what is
happening within CMS, the OIG, and other federal entities that affect
hospice care.
Learning Objectives: Identify the “hot” regulatory issues in the
hospice industry and how they affect hospice providers and the
hospice industry as a whole. Describe the climate within CMS and
the federal government about hospice care. Identify/ locate resources
available and receive answers to outstanding questions.
2B
Oncologic Emergencies and
Advanced Symptom Management
of Cancer Patients
Lorin Yolch, PharmD, CGP, FASCP, Director of Professional
Education, Delta Care RX
There are certain symptom management issues that are unique to
oncology patients who are receiving hospice care. This presentation
will review the palliative care guidelines that are adhered to by
most oncologists regarding the treatment of such patients. Oncologic
emergencies are rare, however, every hospice practitioner
should be familiar with, not only identifying these symptoms, but
confidently managing them as well. Conditions that will be reviewed
include hypercalcemia, superior vena cava syndrome, spinal cord
compression, increased intracranial pressure, coagulation issues, and
cardiotoxicity.
2C
Integrating Massage Therapy
into the Hospice Patient’s Plan of
Care
Ellen M. Liberto, BS, LPN, LMT, CHPLN,
Licensed Massage Therapist, Hospice & Community Care
This presentation will focus on providing an understanding of how
massage therapy can complement a hospice patient’s plan of care.
Topics will include: providing a basic understanding of different
modalities a therapist might use, identifying the role the IDT has in
assessing and referring a patient for massage therapy treatment and
describing the licensed massage therapist’s “process” in developing,
implementing and evaluating a treatment plan.
Learning Objectives: Describe how a massage therapy session is
adapted to meet the specific requirements of a hospice patient. Define
the role of the interdisciplinary team in referring a hospice patient for
massage therapy treatment. Describe the licensed massage therapist’s
process for developing, implementing and evaluating a massage
therapy plan of care.
2D
Resting the Soul: Veterans and
Spirituality
Paul F. Tschudi, EdS, LPC, Professorial Lecturer/Supervisor, The
George Washington University
Veterans may die differently than non-veterans. They may find it
more difficult to have a peaceful death. The mental health field has
determined that 30% of these veterans are suffering from PTSD. But
current literature suggests that many of these individuals returned from
war not with an illness but an injury—a moral/spiritual wound. This
workshop explores these spiritual challenges and how we might assist
veterans in finding some peace at the end of life.
Learning Objectives: Identify the moral/spiritual injuries associated
with military service and combat.
Learning Objectives: Discuss the trends in the demographics of
hospice patients whose primary diagnosis is cancer. Understand the
medical guidelines available regarding treatment of oncology patients.
Review symptoms and treatment options unique to oncology patients.
7
Educational Workshop Schedule
Monday, April 20, 2015
SESSION 3 – 2:45 PM–4:15 PM
3A
How to Achieve and Sustain Stellar
Clinical Documentation
Kathy Baker, MSN, RN; Director Hospice; Christine Smith,
CSSGB, Director, Alignment and Performance Improvement,
Home Nursing Agency Healthcare (A UPMC Company)
Discover how one hospice provider utilized its performance improvement
process to achieve and sustain clinical documentation competency
of all staff. Learn how the provider was able to leverage enhanced
documentation to decrease risk associated with increased regulatory
scrutiny and changing requirements, as well as improve quality of care.
Learning Objectives: Discuss the potential impact on Hospice of
subpar documentation on operations, reimbursement, and compliance.
Identify performance improvement tools that facilitated the improvement
of clinical documentation competencies to meet regulatory and quality
standards. Describe how the team applied technology to the data
collection process to maximize effectiveness, minimize cost, and ensure
ease of use for the end user. Examine the effectiveness of statistical
analysis in validating that true change in performance has occurred
and that high level of performance is sustained.
3B
Preventing Caregiver Moral
Distress Associated With End-of-Life
Patients Dependent on Mechanical
Respiratory Devices
Brenda M. Carroll, RN, MSN, CMSRN, Hospice RN;
Lorraine A. Dickey, MD, MBA, FAAP, Fellow, Hospice &
Palliative Medicine Fellowship; Lori Ann Fontaine, RN,
Hospice RN; Albert Voorhis, MDiv, Ordained, Spiritual
Counselor; Lisa Bickel, RN, Hospice RN, Lehigh Valley
Health Network; Christina Kulp, LCSW, Social Services,
Lehigh Valley Hospice
The purpose of this workshop is to explore mechanical ventilation and
terminal withdrawal from a holistic approach for patients at the end
of life. Participants learn about the withdrawal of C-Pap and other
mechanical support from the physiologic perspective, as well as the
psychosocial and spiritual support required before, during and after
withdrawal. Additionally, participants learn to identify and manage
their own moral distress as well as the distress of their teammates.
Learning Objectives: Demonstrate an increased knowledge of
C-PAP and other life support devices commonly seen in end-of-life care.
Examine the roles of the interdisciplinary team while going through
the process of terminally weaning a patient off of C-PAP. Learn to
proactively identify and address moral distress on the hospice team
when caring for patients and family members before, during and after
8
withdrawal from C-PAP or other respiratory life support. Analyze
educational program development for hospice staff when terminally
weaning a patient from C-PAP.
3C
Holy Cow, What Do We Do Now:
Transitioning Pediatric Patients
Directly From the Intensive Care
Unit to the Home Setting With
Hospice Services
Gwenn LaRagione, RN, BSN, CCM, CHPPN, Nurse
Coordinator, Pediatric Advanced Care Team, Children’s
Hospital of Philadelphia; Shefali Parikh, MD, Attending
Physician, Pediatric Advanced Care Team, Children’s Hospital
of Philadelphia; Wynne Morrison, MD, MBE, Attending
Physician, Children’s Hospital of Philadelphia; Julie Hertz, BSN,
RN, Director of Clinical Care Services, Lighthouse Hospice, Inc.
Most patients and many health care providers are not clear on the
differences between palliative care and hospice. Many patients
may be receiving home care or home palliative care when Hospice
care could fill their needs better. We will explore the differences and
similarities in the different care settings and discuss eliminating barriers
to providing optimal care.
Learning Objectives: Explore issues around advances in health
care, family centered care, and social media that have seemingly
influenced a more intensive and a “never giving up” approach to care.
Provide several scenarios in which discharging a patient directly from
the ICU to home with hospice may be possible including tools and
critical thinking methods that may be used to determine the possibilities
and probabilities. Acknowledge and stress the importance of the
entire interdisciplinary team engaging in maximal communication and
coordination efforts in discharging the complex intensive care patient
safely and efficiently to home with hospice.
3D
No Veterans Die Alone
Cynthia Campbell-Samuels, BSN, CRRN, CHPN, Orthopedic
Care Manager, Lebanon Veterans Administration Medical
Center; Tracey Wheatley, RN, CHPN, Director of Access,
Hospice & Community Care
Hospices are on a mission to learn how to provide comfort from the
challenges Veterans may be facing from illness, seclusion, or war
trauma at the end of life. This session will demonstrate ways volunteers
can be present to talk, read or quietly sit with Veterans who may not
otherwise have someone with them. The session will also review how
this program benefits Veterans as well as hospice Veteran Volunteers.
Learning Objectives: Define three key components required in
developing a “NVDA” program. Describe two essential roles of Veteran
Volunteers. List three major components of a volunteer training program.
Educational Workshop Schedule
Tuesday, April 21, 2015
SESSION 4 − 8:00 AM–9:30 AM
4A
Staying Compliant With the Hospice
Regulations and What New
Regulations Can Hospice Expect
Judy L. Connelly, RN, MSN, Director, Special Projects, Good
Samaritan Hospice of Pittsburgh; Deborah J. Kelly, DNP, RN,
CHPN, Chief Clinical Officer, Clarion Forest VNA Hospice
and Lynn O’Brien, RN, MSN, CHPCA, Director of Hospice,
Abington Hospital Hospice; Susan Smith, MSN, CHPN,
Hospice Manager, Geisinger Columbia Montour Hospice
This panel discussion will present best practices on how to stay
compliant with the hospice regulations and prepare for implementation
of future regulations. This will be an interactive session, please come
prepared to share your best practices and leave with new ideas to
implement now and prepare for the future.
Learning Objectives: Learn best practices to stay in compliance
with the Hospice Conditions of Participation. Identify successful
processes for the CMS skilled nursing requirements for hospice
providers. Familiarize and understand the implementation of the seven
new measures of the Hospice Item Set (HIS) July 1, 2015. Understand
the Proposed Rulemaking for the national emergency preparedness
requirements for Medicare and Medicaid participating providers.
4B
Recognizing, Assessing and
Managing Difficult Pain Syndromes
in Advanced Illness: Bang Head Here
Mary Lynn McPherson, PharmD., BCPS, CPE, Professor and
Vice Chair, Department of Pharmacy Practice and Science,
University of Maryland School of Pharmacy
Hospice and Palliative care practitioners increasing must provide care
for patients who have severe pain in the face of complicated medical
presentations. This may include difficulty assessing the pain complaint
as well as response to therapy, or painful syndromes that do not
respond well to more traditional analgesic regimens. This presentation
will address assessment/reassessment techniques and the use of
more advanced therapeutic strategies such as the use of methadone,
ketamine, lidocaine and other interventions.
4C
But Grandma Has Always Been
On Blood Thinners and Cholesterol
Medicine!
Stanley J. Savinese, DO, CMD, FAAHPM, Medical Director,
VNA Hospice of Philadelphia
We will discuss the strategies used and the rationale behind
streamlining the medication profile of seriously ill patients who enter
hospice care.
Learning Objectives: Review the Pros and Cons of commonly
prescribed medications in Hospice patients. Attain strategies for
communicating with families regarding Rx choices in Hospice patients.
Gain practical knowledge in mechanics of Rx streamlining in Hospice
patients.
4D
I Can’t Fix This with a Pill!:
Identifying and Addressing
Existential Suffering
Ric Baxter, MD, FAAHPM, Director of Palliative Care Services,
St. Luke’s University Health Network; Rev. Anne Huey, MDiv,
MSHS, BCC, Spiritual Services Manager, St. Luke’s Hospice;
Rev. Jim Ingalls, BA, MA Mis, Chaplain, VNA Hospice of
Philadelphia, Temple University Hospital Palliative Care
In the Hospice and Palliative care settings, existential suffering is that
pain which is not reached or lessened by pain meds. It is the search
for meaning in one’s life and in one’s illness. This workshop will offer
an interdisciplinary look at identifying and addressing this very real
pain and suffering with our patients and families.
Learning Objectives: Define existential suffering from actual case
work – presenters’ and attendees’ experiences. Examine responses
to identified suffering. Discuss strategies for examining efficacy of
responses to existential suffering.
Learning Objectives: Describe three assessment strategies used
to evaluate a pain complaint and response to therapy, including
functional status. Recommend a pharmacologic treatment plan aimed
at managing a painful complaint that targets the likely pathogenesis
of the complaint. Describe dosing strategies for methadone, ketamine
and lidocaine, and monitoring parameters to assess outcomes that
guide dosage adjustment.
9
Educational Workshop Schedule
Tuesday, April 21, 2015
SESSION 5 − 10:00 AM–11:30 AM
5A
Pennsylvania Department of Health
Update for Hospice Programs
Linda Chamberlain, MS, BSN, RN, Chief, Division of Home
Health, PA Department of Health
The Department of Health will identify high areas of regulatory
noncompliance deficiencies cited for Pennsylvania hospice programs.
Learning Objectives: Discuss/identify high areas of regulatory
noncompliance. Understand the federal regulations and how they
affect the survey process. Examine and discuss frequently cited
deficiencies and frequently filed complaints.
5B
Providing End of Life Care
Between a Rock and a Hard Place:
Managing Patients With
a History of Substance Abuse
Mary Lynn McPherson, PharmD., BCPS, CPE, Professor and
Vice Chair, Department of Pharmacy Practice and Science,
University of Maryland School of Pharmacy
Managing pain in advanced illness can be challenging enough,
without the added complication of actual or potential substance abuse.
This presentation will address how to recognize and quantify opioid
tolerance (legitimate or illicit), how to dose opioids in opioid-tolerant
patients (including a past history of substance abuse), how to care for
patients in pain who are actively using illicit substances or receiving
opioid agonist therapy, and dealing with a family/caregiver potential
abuse situation.
Learning Objectives: List strategies to detect and assess patients
with an actual or potential history of controlled substances abuse.
Describe strategies used to treat patients receiving opioid agonist
therapy (buprenorphine or methadone) who now require additional
opioid therapy to manage pain. Describe strategies to safely and
effectively management pain in a patient with advanced illness who is
using illicit controlled substances, or a family member or caregiver is
abusing or diverting controlled substances.
10
5C
Palliative Pearls in Caring
for Older Adults
Amy M. Corcoran, MD, CMD, FAAHPM, Associate Professor of
Medicine, Geriatric and Palliative Medicine, Penn State Milton
S. Hershey Medical Center, College of Medicine, Penn State
University
Participants will interact in small groups to discuss ways to assess and
manage common palliative issues in caring for older adults. Cases will
guide the discussion which will focus particularly on issues related to
pain, nutrition, prognostication and caregivers.
Learning Objectives: Define and describe prognostic challenges in
older adults. Identify ways to assess and manage palliative issues in
older adults. Discuss ways to alleviate caregiver distress.
5D
“Once Again, What About Me?”
Addressing the Needs of Grieving
Children and Adolescents
Brian Medkeff-Rose, MDiv, MA, Bereavement Counselor,
Homeland Hospice
Children and adolescents when preparing for or experiencing the
death of a loved one are faced with many challenges. This workshop
will explore ways caring adults may provide support to grieving
children and adolescents as they navigate through their grief journey.
Learning Objectives: Cite appropriate age level responses to grief
and the needs of teens and children. Explore creative interventions
to respond to teen or child’s grief. Discover ways to respond to guilt
or anger. Cite ways to begin difficult conversations with teens and
children and ways to engage the teen or child in support. Discuss risk
factors of grieving teens. Explore what is lost, the nature of the death
and the nature of grief. Discuss rituals and ways children and teens
remember their loved ones.
Registration Information
How to Register
Ground Transportation
Register early for best session workshop selection and
best rate. Registrations may not be shared. Type or
print all information requested since the information
you provide will be used for confirmation letters and
your badge.
Harrisburg International Airport is the nearest
terminal. Shuttle service to the Sheraton Harrisburg
Hershey Hotel is available by calling the hotel front
desk at 717.564.5511.
Payment
Sunday evening cash bar and buffet dinner reception
is included in the full conference registration fee. For
individuals who wish to attend the reception but are
not registered for the full conference, the fee is $30.
Payment must accompany registration (no exceptions).
Registration fee may be paid by check or money
order or by VISA or MasterCard. Mail completed
registration and check made payable to:
Pennsylvania Hospice Network
475 West Governor Road, Suite 7
Hershey, PA 17033
If paying by credit card, you may fax your registration
to PHN at 717-533.4007. Our fax line is always
open so please keep trying if the line is busy. To avoid
duplicate charges, please do not fax and then mail
your registration.
Spouse Rate
$100 enables spouses of conference participants
to attend the Sunday evening event, Monday and
Tuesday lunches and continental breakfasts.
Hotel Reservations
PHN has negotiated a $122 per room, per night,
single or double occupancy rate at the Sheraton
Harrisburg Hershey Hotel in Harrisburg, PA. To
ensure this rate, reservations should be made as soon
as possible and no later than April 13, 2015. Hotel
reservations can be made by calling the Reservations
Department at 1.800.325.3535 or going online to
the Sheraton’s Stargroups website designated for the
PHN Annual Meeting and Conference https://www.
starwoodmeeting.com/Book/PAHospiceNetworkApril
Sunday Evening Event
Registration Cancellation Policy
All cancellations must be submitted in writing to PHN.
A $50 processing fee will apply to all cancellations.
Cancellations received in writing by PHN on or
before April 11, 2015, will receive a full refund less
the processing fee. No refunds will be made on
written cancellations received after April 11, 2015.
Substitutions are welcome; please submit your request
in writing. All refunds will be processed within 30
days after the conference.
We reserve the right to substitute faculty or to cancel
or reschedule sessions due to low enrollment or other
unforeseen circumstances. If the conference must
be cancelled, registrants will receive full credits or
refunds of the paid registration fees. No refunds can
be made for lodging, airfare or any other expenses
related to attending the conference.
Confirmation
Confirmations will be sent to all participants submitting
paid registrations before April 11, 2015.
For Additional Information
Contact the PHN Office at 717.533.4002 or email
[email protected]
Directions
Sheraton Harrisburg Hershey Hotel
4650 Lindle Road
Harrisburg, PA 17111
717.564.5511
www.sheraton.com/harrisburg
11
PHN Annual Meeting & Conference Registration Form
In order to receive discounted pricing, your Registration Form must be faxed/postmarked by the dates below.
Registration fees include breakfast, breaks, luncheon and materials.
Due to material and administrative costs, two day registrations may not be split between two people.
Please check appropriate category
# Participants
Subtotal
o PHN ORGANIZATION MEMBER
• Preconference: (Not included in conference registration fee)
$125
__________ x
$__________
• Monday opening reception:
• (If registering for one day only−Included in full conference registration)
$ 30
__________
x
$__________
• One day conference registration:
$235
__________
x
$__________
• Two day conference registration: (Early bird-postmarked by 3/30/15) $430__________ x
$__________
• Two day conference registration: • (Full conference-postmarked between 3/31/15 & 4/11/15)
$465
$__________
o GROUP RATE (PHN ORGANIZATION MEMBERS ONLY):
$400
__________
x
$__________
• Two day conference registration:
• Two or three from same agency registering at same time
• (Group rate only available if postmarked by 3/30/15)
• Two day conference registration:
• Four or more from same agency registering at same time
• (Group rate only available if postmarked by 3/30/15)
$385
__________
__________
x
x
$__________
Please note that the group discount applies only to full conference participants registering
at the same time from the same agency and postmarked by 3/30/15.
If registering as a group, check the preconference and applicable fees for any individuals of the group
attending the preconference as the preconference is not included in full registration.
o NON PHN ORGANIZATION MEMBER
• One day: (Postmarked by 4/11/15) $400
• Two day conference registration: (Postmarked by 4/11/15)
$650__________ x
__________
x
$__________
$__________
$125__________ x
$210__________ x
$__________
$__________
o HOSPICE VOLUNTEER
• One day: (Postmarked by 4/11/15)
• Two day: (Postmarked by 4/11/15)
Total Amount Enclosed $__________
NOTE: ATTENDEE INFORMATION MUST BE COMPLETED ON PAGE 13.
Registrations postmarked after 4/11/15 and on-site registrations: add $50 for each participant.
Payment:    Check payable to Pennsylvania Hospice Network enclosed
Card Number_________________________________________________________________ Exp. Date __________
Name of Cardholder (Print)__________________________________________________________________________
Authorized Signature_______________________________________________________________________________
Return This Form With Payment To:
PENNSYLVANIA HOSPICE NETWORK, 475 West Governor Road, Suite 7, Hershey, PA 17033
Fax: 717-533-4007 Email: [email protected]
12
Complete for each attendee and copy form as needed.
Last name_____________________________________________________
First name ____________________________________________________
Name on badge ______________________________________________
Registration
Type
1-A_____
4-A_____
Birth date
1-B_____
4-B_____
___/___/___
 No
 Yes
1-C_____
4-C_____
 No
1-D_____
4-D_____
 Nurse
5-A_____
 Social
 Worker
 Full
Organization__________________________________________________
Conference
Phone_________________________________ Fax ___________________
Email_________________________________________________________
CE Credits
Sunday
Reception
Credentials (MD, RN, etc.)______________________________________
City__________________________________ State ____ Zip __________
Tuesday
Workshop
Selections
 Yes
 Precon*
Job Title_______________________________________________________
Address______________________________________________________
Reception
Monday
Workshop
Selections
1-E_____
2-A_____
5-B_____
One day:
2-B_____
5-C_____
 4/20
2-C_____
5-D_____
 4/21
2-D_____
In case of emergency, please contact:
3-A_____
Name________________________________________________________
3-B_____
Phone________________________________________________________
3-C_____
 I would like to request vegetarian meals.
3-D_____
 I require special services to fully participate in the program.
(Attach description of needs)
*Please note: Preconference workshop is not included in the conference registration fee.
Complete for each attendee and copy form as needed.
Last name_____________________________________________________
First name ____________________________________________________
Name on badge ______________________________________________
Monday
Workshop
Selections
Tuesday
Workshop
Selections
CE Credits
1-A_____
4-A_____
Birth date
 Yes
Sunday
Reception
1-B_____
4-B_____
___/___/___
 No
 Yes
1-C_____
4-C_____
 No
1-D_____
4-D_____
 Nurse
5-A_____
 Social
 Worker
Registration
Type
 Precon*
Job Title_______________________________________________________
Credentials (MD, RN, etc.)______________________________________
 Full
Organization__________________________________________________
Conference
Address______________________________________________________
City__________________________________ State ____ Zip __________
Phone_________________________________ Fax ___________________
Email_________________________________________________________
Reception
1-E_____
2-A_____
5-B_____
One day:
2-B_____
5-C_____
 4/20
2-C_____
5-D_____
 4/21
2-D_____
In case of emergency, please contact:
3-A_____
Name________________________________________________________
3-B_____
Phone________________________________________________________
3-C_____
 I would like to request vegetarian meals.
3-D_____
 I require special services to fully participate in the program.
(Attach description of needs)
*Please note: Preconference workshop is not included in the conference registration fee.
If more than one registration is being submitted,
name of person completing this form:
Name_____________________________________________________
PENNSYLVANIA HOSPICE NETWORK
475 West Governor Road, Suite 7, Hershey, PA 17033
Phone number______________________Email ___________________
Fax: 717-533-4007
RETURN THIS FORM WITH PAYMENT TO:
13
General Information
Badges
Attire
Please wear your registration name badge at all
times—it is your admission ticket to pre-conference
and conference sessions.
Conference dress is business casual. While the hotel
staff does their best to provide a comfortable climate
for our conference, sometimes it may be warmer or
cooler than you prefer. A sweater or light jacket may
be necessary.
Professional Credits Information
The Pennsylvania Hospice Network will issue a
Certificate of Attendance for continuing education
units (CEU) as follows:
Sunday, April 19 – 3.75
Monday, April 20 – 5.75
Tuesday, April 21 – 4
This activity has been submitted to the State Board
of Social Workers, Marriage and Family Therapists
and Professional Counselors for approval to award
continuing education credit hours as follows:
Sunday, April 19 – 3.75
Monday, April 20 – 5.75
Tuesday, April 21 – 4
This activity has been submitted to the PA State
Nurses Association for approval to award contact
hours. PA State Nurses Association is accredited as
an approver of continuing nursing education by the
American Nurses Credentialing Center’s Commission
on Accreditation.
For more information, please call Susan Metz at the
Pennsylvania Hospice Network at 717.533.4002.
Program evaluations must be completed and turned
in to the conference registration table to get your
certificate. For questions related to continuing
education credits, please contact the Pennsylvania
Hospice Network at 717.533.4002.
Special Assistance
If you need additional assistance with accommodations
or with participating in conference workshops or
events, please check the box on the registration form.
Smoking Policy/Cell Phones
For the comfort and health of all attendees, smoking
is not permitted in any of the sessions, including the
pre-conference and social functions.
Please remember to turn off cellular phones and
pagers during sessions.
14
Photo Release
A photographer may be present at this event to take
pictures that will include participants. These photos
may be used by the event organizers for purposes of
promotion. Please notify the Pennsylvania Hospice
Network at [email protected] if you do NOT
permit your photo to be used for this purpose.
Contact Information
Pennsylvania Hospice Network
475 W. Governor Road, Suite 7
Hershey, PA 17033
Phone: 717-533-4002
Fax: 717-533-4007
Email: [email protected]
Website: www.pahospice.org
2015 Organization Members
Abington Memorial Hospital Home Care Hospice
Abramson Hospice
Amedisys Hospice of PA
AseraCare Hospice-Altoona
AseraCare Hospice-Clarks Summit
AseraCare Hospice-Erie
AseraCare Hospice-Exton
AseraCare Hospice-Harrisburg
AseraCare Hospice-Pittsburgh
AseraCare Hospice-York
At Home Hospice Care
Bayada Hospice
Bethlen Communities Home Health Services & Hospice
Bridges Hospice
Celtic Hospice & Palliative Care Services of Carlisle
Clarion Forest VNA Hospice
Clearfield Hospital Hospice
Compassionate Care Hospice
Crossroads Hospice
Delaware Hospice Inc.
Doylestown Hospital Hospice
Einstein Montgomery Hospice
Eleanor’s Garden
Erickson Living Health Services
Erwine Home Health & Hospice, Inc.
Evangelical Hospice
Forbes Hospice
Foulkeways Hospice
Geisinger Columbia Montour Hospice
Gentiva Hospice-Blue Bell
Gentiva Hospice-Pittsburgh
Great Lakes Hospice
Helping Hands Hospice, Inc.
Holisticare Hospice
Home Nursing Agency
Homeland Hospice
Hospice & Community Care
Hospice of Central PA
Hospice of Crawford County
Hospice of Metropolitan Erie
Hospice of Warren County
In Touch Hospice
Interim Healthcare Hospice
Jameson Hospice of Lawrence County
Karen Ann Quinlan Hospice
Lehigh Valley Hospice
Liberty Hospice
Life Choice Hospice
Lutheran Home Care & Hospice, Inc.-Allentown
Lutheran Home Care & Hospice, Inc.-Chambersburg
Lutheran Home Care & Hospice, Inc.-Hazle Township
Lutheran Home Care & Hospice, Inc.-Wyomissing
Masonic Village Hospice
Maylath Valley Health Systems, Inc.
Montgomery Hospital Hospice
Nason Hospital Hospice
Neighborhood Hospice
Paramount Hospice & Palliative Care
Seasons Hospice & Palliative Care of Pennsylvania
Seven Oaks Hospice Care, LLC
Sharon Regional Hospice & Palliative Care
St. Luke’s Hospice
Susquehanna Hospice
VNA Hospice of Monroe County
VNA Hospice of Philadelphia
VNA Hospice, Western PA
VNA of Hanover and Spring Grove Hospice
VNA of Venango County Hospice
Washington Health Systems Hospice Care
Willow Tree Hospice
Windber Hospice
*Organization members at time of publication
15
Pennsylvania Hospice Network
Promoting Excellence in End-of-Life Care
2015 Board of Directors
~ OFFICERS ~
President
Ric Baxter, MD, FAAHPM
Chief of Pain Medicine/Palliative Care
St. Luke’s Hospital and Health Network
Vice President
Rev. Anne G. Huey, MDiv, MSHS, BCC
Spiritual Services Manager
St. Luke’s Hospice
Treasurer
Judy L. Connelly, RN, MSN
Director, Special Projects
Good Samaritan Hospice of Pittsburgh
Secretary
Rev. Jim Ingalls, BA, MA Mis
VNA Hospice of Philadelphia
Temple University Hospital Palliative Care
Jane Feinman, MSN, RN
Executive VP of Hospice & Palliative Care
VNA Hospice of Philadelphia
Deborah J. Kelly, PhD, RN, MSN, CHPN
Chief Clinical Officer
Clarion Forest VNA Hospice
Lannette M.T. McWilliams, BA
Director
Seven Oaks Hospice Care, LLC
Madeline ‘Lynn’ O’Brien, RN, MSN, CHPCA
Director of Hospice
Abington Hospital Hospice
Paige E. Payne, MS, MSW, LSW, ACHP-SW
Director of York Hospice
Hospice & Community Care
Cynthia Campbell-Samuels, RN, BSN
Orthopedic Care Manager
Lebanon VA Medical Center
Susan B. Smith, MSN, CHPN
Hospice Manager
Geisinger Columbia Montour Hospice
Vickie L. Carolla, RN, CHPN
Director of Operations
Amedisys Hospice of PA
Lisa To, RN, BSN, MBA
Executive Director
Hospice of Warren County