{"ref":"CA-HSP-ELC-02","title":"Certification and Recertification of Terminal Illness and Face-to-Face Encounters","category":"Hospice care","summary":"Sets out how terminal illness is certified and recertified: California's initial certification by the Medical Director or Medical Director Designee with a 12-month attestation and an individual narrative written immediately above the physician's signature; the Medicare 6-month certification, timing, sources and narrative rules; face-to-face encounters before the third and later benefit periods; and the safeguards that keep eligibility decisions honest.","inShort":["The Medical Director or Designee certifies terminal illness with the patient's attending physician.","The physician writes the reasons in their own words, right above their signature. No check boxes or standard wording.","Give the physician current clinical information in time, but never suggest what to conclude.","Recertification is due before every new benefit period. Watch the calendar.","Before the third benefit period and each one after, a hospice physician or nurse practitioner must see the patient face to face within the 30 days before."],"primaryCitation":"22 CCR §74860(c)","citations":["22 CCR §74860(c)-(d)","22 CCR §74892(b)","22 CCR §74832(b)(4)","Cal. Health & Safety Code §1746(p)","Cal. Health & Safety Code §1755(a)(1)"],"federalCitations":["42 CFR §418.22","42 CFR §418.21","42 CFR §418.25","42 CFR §418.102(b)-(c)","42 CFR §418.104(a)(5)"],"surveyorAsks":["Show me the initial certification for this patient. Who signed it, and where is the narrative?","How do you make sure the narrative is written by the physician and is not standard language?"],"forms":[{"ref":"CA-HSP-ELC-02-A","title":"Certification of Terminal Illness (California Narrative Format)"},{"ref":"CA-HSP-ELC-02-B","title":"Face-to-Face Encounter Attestation"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (22 CCR §74860(c))","5. Before Certifying","6. The Initial Certification (California and Medicare)","7. Timing (If the Agency Is Medicare-Certified)","8. Recertification","9. Face-to-Face Encounters (If the Agency Is Medicare-Certified)","10. Tracking Due Dates","11. Integrity Safeguards","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"ca-hospice","state":"California","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}