Eli's Hospice Insider

Hospice evacuated in one state.

Hurricane season may be over, but winter storm season is yet another reason your emergency preparedness plans should be at the ready.

Hospices impacted by Hurricane Sandy learned some lessons about their plans the hard way. In advance of the storm, hospices all up and down the Eastern seaboard prepared for the worst.

For example: Gilchrist Hospice Care in Towson, Md. ordered extra supplies of medication for patients and planned to be prepared to visit dying patients even as the storm worsened, reported The Baltimore Sun newspaper. They had moved at least one patient who gets care at home to an inpatient facility to cut down on the risk of complications.

"When you have 600 patients, you have someone at any given time who is actively dying," Gilchrist’s Regina Bodnar told the newspaper. "Our goal is to attend 100 percent of deaths."

The hospice planned to have workers strategically located at its area offices. Four-wheel drive vehicles would be available for workers to get out.

Some providers saw their emergency plans put into action. Connecticut Hospice in Branford, Ct. underwent an evacuation, according to press reports. The fire department evacuated all patients to St. Raphael’s and Yale-New Haven Hospital.

HHH Medicare Administrative Contractor Palmetto GBA sent a listserv message assuring providers it would help with any disruptions caused by Hurricane Sandy. The message included information on electronic claims processing, contacting customer service, and more.

Once the storm hit, resourceful clinicians, aides and other hospice and home care personnel surmounted flooding, impassable roads, downed trees and dwindling gasoline to get to their patients, reports National Public Radio. "It’s just been incredible to see everybody step up, even though they themselves have been without child care, school’s not in session, their homes are cold, they don’t have much food, they’re having to wait in line for hours and hours for gasoline," Dr. Steve Landers of VNA Health Group of New Jersey told the radio program. "I’m sort of speechless. It’s just amazing."

"I’ve been in very close contact with agencies throughout New Jersey and it’s amazing what people are doing," added Sherl Brandt of the Home Care Association of New Jersey. "I don’t know of any cases where people didn’t get needed care." Home care staffers provided services ranging from delivering a baby for a woman stuck in traffic to driving a kidney failure patient to a distant dialysis center.

Visiting Nurse Association of Long Island nurses walked to their patients’ homes, the VNA’s Orael Keenan told NPR.

Eloise Goldberg of the Visiting Nurse Service of New York worked on figuring out how to get 11,000 home health aides and 3,500 clinicians to their patients after the storm. "We had been preparing our field staff for several days so they would have cell phone connections with their patients, but now we were up against massive flooding and blackouts and fires," Goldberg told Newsweek magazine.

In the Rockaways, one VNA nurse walked seven blocks through knee-high water to get to a group home, Newsweek says. Another walked up 12 flights to administer medication and calm the patient, who, like tens of thousands of others, was sitting in the dark with no TV, water or gas service.

Durable medical equipment providers made sure to make deliveries ahead of the storm so patients would have necessary oxygen and other items. And some, like Metrostar Home Health Products in Brooklyn, N.Y. have been collecting other items for victims. Metrostar has run a clothing, food, water, and fund drive for impacted New Yorkers, it says on its website. Thousands of homeless residents lack basic necessities, the supplier says.

Fuel shortages were the biggest problem many hospice and home care providers in New York and New Jersey had to conquer. But in New Jersey, home care agencies said state fuel depots were filling their tanks once emergency vehicles were taken care of. At gas stations, some nurses were able to go to the head of the line when they showed their ID and explain the situation, the radio program says.

Use This Code For Waiver-Covered Claims

Waivers for certain Medicare regulations were effective Oct. 26 for New Jersey and Oct. 27 for New York due to Hurricane Sandy, the Centers for Medicare & Medicaid Services confirmed in a MLN Matters article issued after the storm. "Use of the ‘DR’ condition code and the ‘CR’ modifier are mandatory on claims for items and services for which Medicare payment is conditioned on the presence of a formal waiver," CMS reminded in article # SE1247.

Hospices in affected areas received a blanket waiver from aide supervision requirements. Contractors could, at their discretion, provide a beneficiary’s HICN for billing purposes during a public health emergency, CMS added.

More information is online at www.cms.gov/Emergency.