Session Information

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Conference Schedule

Session Title
7:00 AM - 8:00 AMNetworking Breakfast and Registration
8:00 AM - 8:20 AMWelcome Announcements and Chapter Business Meeting
8:20 AM - 9:20 AMSession 1: MOON 2 Midnight
9:25 AM - 10:20 AMNetworking Break with Sponsors and Exhibitors
10:25 AM - 11:25 AMSession 2: Beyond Medical Futility
11:30 AM - 12:30 PMSession 3: Panel: Transitions of Care
12:30 PM - 2:00 PMNetworking Lunch with Sponsors and Exhibitors
2:05 PM - 3:05 PMSession 4: Harm Reduction for Substance Use: Meeting Clients Where They’re At
3:10 PM - 4:10 PMSession 5: Reducing Readmissions Through Whole-Person Transitional Care
4:10 PM - 4:15 PMClosing Remarks
4:20 PM - 6:00 PMNetworking Reception: Stay and Wait Out the Traffic with Us!

Session 1: MOON 2 Midnight

Joseph Zebrowitz, MD
Versalus Health · Newtown Square, PA


In December 2016, the Office of Inspector General (OIG) issued a report stating that vulnerabilities exists under the Two-Midnight (2MN) Rule. In the report, the OIG recommended to the Centers for Medicare & Medicaid Services’ (CMS) that it conducts periodic analysis of hospital billing and targets hospitals with increasing numbers of short stay inpatient stays. CMS agreed with the recommendations from the OIG and clarified its requirements for medical reviews for Part A payment of short-stays under the Two-Midnight Rule. The Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIO) have changed their approach and are now using a data-driven approach to sampling, reviewing and targeting the top 175 hospitals in each BFCC-QIO area. This session will study the OIG Report on vulnerabilities related to the 2MN Rule process, the implications for hospitals and discuss recommendations for addressing the issues. In addition, the speaker will provide an update on the BFCC-QIO audits and lessons learned. An examination of the latest regulatory requirements for compliance with the Medicare Outpatient Observation Notice (MOON) as required by the NOTICE Act, Condition Code 44, Condition Code W2 as well as a discussion on any new regulatory provisions related to Inpatient and Observation included in 2018 Outpatient Prospective Payment System (OPPS) will be provided.


  1. Understand the OIG Report implications for hospitals' Utilization Review programs
  2. Learn how to safeguard your processes so you are not a target of BFCC-QIO audits and review a recent hospital experience with an audit
  3. Examine MOON requirements and implementation, Condition Code 44, and Condition Code W2 in the 2MN Rule Era

Session 2: Beyond Medical Futility

Juan Iregui, MD, MA, FAAHPM
Palliative Medicine Physician and Bioethicist · Franciscan Hospice and Palliative Care
CHI Franciscan Health · University Place, WA

This session will allow the audience to discuss the practical medico-legal aspects of ethics discernment around medical futility and decisional capacity. 


  1. Practice using a framework to assess decisional capacity
  2. Review practical medico-legal aspects of futility
  3. Become familiar with the practical aspects of ethics discernment

Session 3: Panel: Transitions of Care

Gwyn Palchak, BSN, RN-BC, ACM-RN

· Kalispell, MT

Carol Ridenhour, MN, RN, ACM-RN

· Seattle, WA

Steven M. Case, RN, BSN, CCM

· Newport, WA

Kim Barwell, RN, MN, ACM-RN

· Tacoma, WA


Multiple challenges present with patients and the hand off of care when it comes to transitions of care. This session will explore resources are available to support the patient in their healthcare management are explored. In the process of formulating a discharge plan the case manager may experience moral distress as a result of not being able to solve pre-existing long-term problems a patient has prior to hospitalization. 


  1. List the resources available to support patients and to prevent readmission
  2. State some of the challenges involved in transitions of care for patients
  3. Provide open discussion regarding transitions of care

Session 4: Harm Reduction for Substance Use: Meeting Clients Where They’re At

Susan Collins, Ph.D.
Director · HAART Center
University of Washington – Harborview Medical Center · Seattle, WA


This session will train clinicians on harm reduction treatment. The speaker will share her vision to co-create with communities a toolbox of harm reduction interventions that empower individuals to reduce their substance related harm and improve their quality of life.


  1. Describe harm reduction treatment
  2. Identify interventions that help individuals reduce their substance related harm
  3. Apply basic tools of harm reduction

Session 5: Reducing Readmissions Through Whole-Person Transitional Care

Trish L.Anderson, MBA, BSN
Director of Quality & Performance Improvement for Patient Safety
Washington State Hospital Association · Seattle, WA


Readmissions has been a national priority for years and despite the multiple efforts Washington hospitals have put in place to reduce readmissions, rates have not significantly improved. Using the Agency of Healthcare Research and Quality’s ASPIRE toolkit as a guide, we will establish new standards for transitioning care that apply to all patients regardless of readmission risk. This session will shift the focus of readmissions reduction efforts from interventions done to the patient to transitional care plans designed with the patient.


  1. Recognize the difference between discharge planning and whole-person transitional care
  2. Apply patient interview strategy to root cause analysis
  3. Evaluate discharge planning practices and identify opportunities for improvement

Washington  Chapter Annual Conference Links
June 15, 2018


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