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BAYADA Hospice LTC Business Development Playbook Index

For BAYADA Sales Training Only Confidenal| 2 Contents Hospice Playbook: Tools and Resources .....................................................................................................................5 Sales Collateral, Resources, and Educaon By Role................................................................................................5 Campaigns & Collateral ..............................................................................................................................................7 GENERAL .................................................................................................................................................................7 Success with Muse Resources and Training ........................................................................................................7 Let’s Talk About Hospice (Misconcepons) ........................................................................................................7 Call Us First Flyer.................................................................................................................................................7 Mr. Cunningham Case Study ...............................................................................................................................7 The Value of Hospice ..........................................................................................................................................8 Earlier is Beer Flyer ...........................................................................................................................................8 How Hospice Helps Flyer ....................................................................................................................................8 Hospice Indicators Card ......................................................................................................................................8 Social Determinants-Hospice (Updated Version Pending) .................................................................................8 Volunteer Resources ...........................................................................................................................................9 Hospice Volunteer Flyer ......................................................................................................................................9 Hospice Coverage Maps (Pending) .....................................................................................................................9 Bereavement Resources .....................................................................................................................................9 SalesBites-The Hospice Edion ............................................................................................................................ 10 Hospice Eligibility Flip Book ............................................................................................................................. 10 StorySelling ...................................................................................................................................................... 10 Launching Digital Sales Strategies ................................................................................................................... 10 The Paent and Family Meeng (Sales BITE XL) .............................................................................................. 10 Veteran’s Resources ............................................................................................................................................. 11 Veteran’s Day Flyer .......................................................................................................................................... 11 Veteran’s Cerficates ....................................................................................................................................... 11 Advanced Cancer Campaign ................................................................................................................................ 12 Hospice Cancer Referral................................................................................................................................... 12 Hospice Paent Facing Cancer Flyer ................................................................................................................ 12 Neurologic Related Hospice Sales Resources ...................................................................................................... 13 TRAINING ......................................................................................................................................................... 13 Demena-Related Eligibility Flyer .................................................................................................................... 13 Hospice Demena Flyer with FAST Scale ......................................................................................................... 14

For BAYADA Sales Training Only Confidenal| 3 Cardiac Related Hospice Resources ..................................................................................................................... 15 Heart Disease Hospice Indicator Flyers ........................................................................................................... 15 Managing Your ESHF Paent Facing ................................................................................................................ 15 ‘Earlier is Beer’ Email and Social Media Campaign ........................................................................................... 17 Earlier is the Beer Hospice Sales Campaign Guide ........................................................................................ 17 EIB October 2, 2023, Rollout Webinar ............................................................................................................. 17 EIB Rollout Slides ............................................................................................................................................. 17 MyEmma Email Plaorm ................................................................................................................................. 17 EIB Resource Crosswalk ................................................................................................................................... 17 Weeks 1-4: Quality Time with Those Most Important .................................................................................... 18 Weeks 5-8: The Value of Sooner is Beer ....................................................................................................... 18 Weeks 9-12: Disease-Specific Benefits of Early Hospice Referrals .................................................................. 18 Referral Source Training Resources ..................................................................................................................... 19 Introducon to Hospice Care ........................................................................................................................... 19 Common Hospice Misconcepons .................................................................................................................. 19 Hospice Sales Training & Resources: Themes and Descripons .......................................................................... 20 DATA-DRIVEN SALES STRATEGIES ..................................................................................................................... 20 HOSPICE DISCOVERY QUESTIONS .................................................................................................................... 20 HOSPICE 101 TOOLS ........................................................................................................................................ 20 HOSPICE ELIGIBILITY RESOURCES .................................................................................................................... 20 MINI SALES BOOT CAMP HOSPICE TRAINING .................................................................................................. 21 Resource-Hospice Service Office Profile Tool .................................................................................................. 22 Hospice 101-Handling Hospice Objecons ...................................................................................................... 22 Hospice 101-Palliave Care Sales Training ...................................................................................................... 22 The Hospice Referral Checklist & Paent and Family Meeng Training .......................................................... 22 Resource-Hospice Referral Intake Checklist-All Brands ................................................................................... 23 Resource-Paent and Family Meeng Tip Sheet ............................................................................................. 23 Hospice Office Profile Tool-editable 3.23 ........................................................................................................ 23 BAYADA Hospice Business Development Playbook ................................................................................................. 24 Geng to Know the Key Decision Makers........................................................................................................... 25 Importance of Account Profiling and Needs Discovery ....................................................................................... 27 Open-Ended Discovery Quesons ................................................................................................................... 28 Using Stories and Case Studies in Business Development .................................................................................. 31

For BAYADA Sales Training Only Confidenal| 4 Example: Case Study 1: Posive Outcome for the LTC Facility ....................................................................... 32 Example: Case Study 2: Posive Outcome for the Resident and Family (With Data References) .................. 33 Example: Case Study 3: Posive Outcome for the Resident, Family, and Staff............................................... 35 The Business End ................................................................................................................................................. 37 Hospice and Long Term Care Facility Collaboraon ............................................................................................ 38 Hospice Levels of care in the Long Term Care Facility ......................................................................................... 41 How Hospice is Billed in the LTC .......................................................................................................................... 43 Best Pracce for Hospice Business Development: .............................................................................................. 46 Addional Resources ........................................................................................................................................... 48 Account Profiling ............................................................................................................................................. 48 Handling Objecons ........................................................................................................................................ 48 Introducon to Care Planning for Long-Term Residents with Chronic Diseases ............................................. 48 Introducon to Care Planning for Long-Term Residents with Chronic Diseases ................................................. 58

For BAYADA Sales Training Only Confidenal| 5 Hospice Playbook: Tools and Resources Introduction Sales Collateral, Resources, and Education By Role When using business development collateral and resources, it’s important to tailor the materials to address the specific needs and interests of each role within the long-term care (LTC) facility. Here are some suggestions for valuable collateral for each key decision maker: Administrator • Financial Impact Reports: Highlight cost savings from reduced hospitalizations and improved reimbursement rates. • Case Studies: Showcase successful partnerships with other LTC facilities, emphasizing financial and operational benefits. • Regulatory Compliance Guides: Explain how hospice services help meet CMS quality measures and regulatory requirements. Director of Nursing (DON) • Clinical Outcome Reports: Provide data on improved patient outcomes, such as pain management and reduced hospital readmissions. • Training and Support Materials: Detail the training and support provided to nursing staff by BAYADA Hospice. • Quality Improvement Case Studies: Highlight examples of improved care quality and patient satisfaction. Nursing Supervisors • Patient Care Brochures: Explain the benefits of hospice care for patients, including pain and symptom management. • Staff Support Information: Outline the support and resources available to nursing staff from BAYADA Hospice. • Family Feedback Reports: Share testimonials and feedback from families about the positive impact of hospice care. Social Service Designees / Directors of Social Service • Patient and Family Education Materials: Provide brochures and guides that explain hospice services to patients and families. • Referral Process Guides: Detail the steps for making hospice referrals and the support available during the process.

For BAYADA Sales Training Only Confidenal| 6 • Emotional and Spiritual Support Information: Highlight the counseling and support services offered to patients and families. Director of Staff Development (DSD) • Training Program Outlines: Detail the hospice education and training programs available for certified nursing assistants. • In-Service Training Materials: Provide resources for scheduling and conducting in-service training sessions on hospice care. • Staff Testimonials: Share success stories from staff who have benefited from hospice training and support. MDS Coordinator • Documentation and Compliance Guides: Explain how hospice services support accurate documentation and compliance with CMS requirements. • Medicare Eligibility Information: Provide details on hospice eligibility criteria and how to identify eligible patients. • Case Studies: Highlight successful transitions from skilled care to hospice and the benefits for Medicare patients. Admissions Team • Marketing Brochures: Provide materials that explain the benefits of BAYADA Hospice to prospective residents and their families. • Referral Advocacy Guides: Detail how the admissions team can advocate for BAYADA Hospice during the admissions process. • Family Testimonials: Share positive feedback from families who have experienced BAYADA Hospice care. Business Office Manager • Financial Impact Reports: Highlight the cost savings and financial benefits of partnering with BAYADA Hospice. • Contract and Reimbursement Guides: Provide information on managing contracts and understanding reimbursement rates. • Case Studies: Showcase examples of improved financial performance and operational efficiency through hospice partnerships. By using these tailored pieces of collateral, you can effectively communicate the value of BAYADA Hospice services to each key decision maker within the LTC facility, addressing their specific needs and concerns.

For BAYADA Sales Training Only Confidenal| 7 Campaigns & Collateral Location: https://hospice.bayada.com/growth/campaigns-collateral/ GENERAL BAYADA Hospice Resource Index for Long-Term Care Facilities Success with Muse Resources and Training Theme: Enhancing Care Quality and Efficiency • Pain Point: LTC facilities often struggle with maintaining high-quality care while managing limited resources. • Solution: Muse technology improves care planning accuracy, increases bedside time, and enhances the quality of care, addressing both efficiency and quality concerns. Let’s Talk About Hospice (Misconceptions) Theme: Educating and Reassuring Families • Pain Point: Families often have misconceptions about hospice care, leading to hesitation in utilizing these services. • Solution: Providing clear, accurate information helps families understand the benefits of hospice care, easing their concerns and facilitating better decision-making. Call Us First Flyer Theme: Streamlining Communication and Coordination • Pain Point: LTC facilities need efficient communication channels to coordinate care effectively. • Solution: The “Call Us First” flyer ensures that hospice services are integrated seamlessly, improving coordination and reducing unnecessary hospitalizations. Mr. Cunningham Case Study Theme: Demonstrating Real-World Impact • Pain Point: Decision-makers need concrete examples of how hospice care can benefit their residents. • Solution: Case studies like Mr. Cunningham’s provide tangible evidence of improved patient outcomes and family satisfaction, making a compelling case for hospice services.

For BAYADA Sales Training Only Confidenal| 8 The Value of Hospice Theme: The data-rich evidence backed resource supports the integration of hospice services in long-term care facilities to significantly reduce costs, improve patient outcomes, and enhance compliance with regulatory quality measures. • Pain Point: LTC facilities need clear, concise information to present to families and staff. • Solution: Infographics provide an easy-to-understand visual representation of hospice benefits, making it easier to communicate key points. Earlier is Better Flyer Theme: Promoting Early Intervention • Pain Point: Delayed hospice referrals can lead to missed opportunities for optimal care. • Solution: Emphasizing the benefits of early hospice intervention helps ensure residents receive timely and appropriate care. How Hospice Helps Flyer Theme: Comprehensive Care Overview • Pain Point: LTC staff and families may not fully understand the scope of hospice services. • Solution: Providing a detailed overview of hospice care helps clarify its comprehensive nature and benefits. Hospice Indicators Card Theme: Identifying Eligible Residents • Pain Point: LTC staff need clear criteria to identify residents who may benefit from hospice care. • Solution: The Hospice Indicators Card provides easy-to-use guidelines for determining hospice eligibility. Social Determinants-Hospice (Updated Version Pending) Theme: Addressing Social Determinants of Health • Pain Point: Social determinants can significantly impact residents’ health outcomes. • Solution: Understanding and addressing these factors can improve care quality and resident well-being. •

For BAYADA Sales Training Only Confidenal| 9 Volunteer Resources Unique Volunteer Program (Inviting the Bereaved to Volunteer) Theme: Enhancing Community and Support • Pain Point: LTC facilities often seek ways to enhance community involvement and support for residents. • Solution: Inviting the bereaved to volunteer provides additional support and fosters a sense of community. Hospice Volunteer Flyer Theme: Promoting Volunteer Engagement • Pain Point: LTC facilities need to engage volunteers to support residents and staff. • Solution: The Hospice Volunteer Flyer helps recruit and inform potential volunteers about opportunities to contribute. Hospice Coverage Maps (Pending) Theme: Ensuring Accessibility • Pain Point: LTC facilities need to know the geographic coverage of hospice services. • Solution: Coverage maps provide clear information on service areas, ensuring that facilities can access hospice care when needed. o NC HOS Coverage Map – Link Bereavement Resources Theme: Supporting Families After Loss • Pain Point: Families need ongoing support after the loss of a loved one. • Solution: Bereavement resources offer continued support, helping families cope with their grief. This index aligns the sales resources with a few general pain points of decision-makers in long-term care facilities, providing targeted resources that address their unique challenges.

For BAYADA Sales Training Only Confidenal| 10 SalesBites-The Hospice Edition Hospice Eligibility Flip Book Theme: Hospice Eligibility Flip Book Best Practices • Pain Point: LTC staff struggle with transitioning residents to hospice care due to a lack of clear guidelines. • Solution: Offer a Hospice Eligibility Booklet to assist staff with effectively identifying and transitioning eligible patients to hospice services. StorySelling Theme: Discover effective practices for sales collateral • Pain Point: LTC staff often feel overwhelmed and uncertain about how to initiate end-of-life care conversations • Solution: Success stories about a resident who experienced improved comfort and quality of life through timely hospice care, highlights the value for both the resident and the LTC staff. Launching Digital Sales Strategies Theme: A four-part series highlighting best practices for selling with email • Pain Point: LTC staff often lack timely updates and clear communication about hospice eligibility and services, leading to missed opportunities for appropriate patient care • Solution: Sending regular, informative emails can provide clear guidelines, success stories, and updates, helping the LTC staff stay informed and confident in making timely hospice referrals. The Patient and Family Meeting (Sales BITE XL) Theme: Enhancing Communication for Hospice Discussions • Pain Point: LTC staff often feel uncomfortable and unprepared to initiate hospice discussions with patients and their families. o Solution: Provide comprehensive training and role-playing exercises to build confidence and communication skills for these sensitive conversations

For BAYADA Sales Training Only Confidenal| 11 Veteran’s Resources Veteran’s Day Flyer Theme: Honoring Our Veterans • Pain Point: LTC facilities often struggle to effectively recognize and honor their veteran residents, leading to feelings of neglect and underappreciation among veterans. • Solution: Create and distribute a Veteran’s Day Flyer that highlights the significance of Veterans Day, includes a schedule of events, and features stories or quotes from veteran residents, ensuring they feel valued and celebrated. Veteran’s Certificates Theme: Celebrating Service and Sacrifice • Pain Point: LTC facilities may lack formal recognition programs for veteran residents, resulting in missed opportunities to acknowledge their service and contributions. • Solution: Provide personalized Veteran’s Certificates to honor and recognize the service of veteran residents, presenting them during special ceremonies or events to foster a sense of pride and appreciation.

For BAYADA Sales Training Only Confidenal| 12 Advanced Cancer Campaign Hospice Cancer Referral Theme: Facilitating Timely Cancer Referrals • Pain Point: LTC staff often face challenges in identifying and referring advanced cancer patients to hospice care in a timely manner. • Solution: Resource provides clear guidelines and criteria for referring cancer patients to hospice, ensuring staff can make informed and timely referrals to improve patient care. Hospice Patient Facing Cancer Flyer Theme: Empowering Patients with Information • Pain Point: Patients with advanced cancer and their families often lack understanding of hospice services and how they can benefit from them. • Solution: This Patient Facing Flyer explains hospice services, benefits, and eligibility in a patient-friendly manner, empowering patients and families to make informed decisions about their care.

For BAYADA Sales Training Only Confidenal| 13 Neurologic Related Hospice Sales Resources TRAINING Hospice Eligibility Webinar - Neurological Diseases Theme: Enhancing Knowledge on Neurological Disease Eligibility • Long-Term Care Pain Point: LTC staff often lack specific knowledge about hospice eligibility criteria for patients with neurological diseases. • Solution: A comprehensive Hospice Eligibility Webinar focused on neurological diseases, to assist BD staff understand how to communicate the importance of timely and appropriate referrals. The Hospice Eligible Patient Part One (Neurological Diseases) - Webinar Theme: Identifying Hospice-Eligible Neurological Patients • Pain Point: LTC Staff struggle to recognize when patients with neurological diseases are eligible for hospice care. • Solution: “The Hospice Eligible Patient Part One,” covers the signs and criteria for hospice eligibility in neurological diseases, to assist BD staff understand how to communicate the importance of timely and appropriate referrals. Hospice Eligible Patient (Part One) Slides Theme: Accessible Training Materials • Pain Point: Staff need easy access to training materials for reference and review. • Solution: Link to the slides from “The Hospice Eligible Patient Part One” webinar, allowing staff to revisit and reinforce their understanding of hospice eligibility for neurological diseases. RESOURCES Dementia-Related Eligibility Flyer Theme: Simplifying Dementia Eligibility Criteria • Long-Term Care Pain Point: LTC staff often find it challenging to determine hospice eligibility for residents with dementia. • Solution: Distribute a Dementia-Related Eligibility Flyer that clearly outlines the criteria for hospice eligibility in dementia patients, helping staff make informed decisions.

For BAYADA Sales Training Only Confidenal| 14 Hospice Dementia Flyer with FAST Scale Theme: Utilizing the FAST Scale for Dementia Patients • Long-Term Care Pain Point: Staff need a reliable tool to assess the progression of dementia and determine hospice eligibility. • Solution: Hospice Dementia Flyer includes the Functional Assessment Staging (FAST) Scale, offering a practical tool for staff to evaluate dementia progression and identify eligible patients for hospice care.

For BAYADA Sales Training Only Confidenal| 15 Cardiac Related Hospice Resources Internal Education Only: The Cardiac Eligible Patient Theme: Identifying Hospice-Eligible Cardiac Patients • Pain Point: LTC staff often struggle to identify when patients with cardiac conditions are eligible for hospice care. • Solution: “The Cardiac Eligible Patient,” covers the signs and criteria for hospice eligibility in cardiac patients, to assist BD staff understand how to communicate the importance of timely and appropriate referrals. Webinar Slides Theme: Accessible Training Materials • Pain Point: Staff need easy access to training materials for reference and review. • Solution: Link to the slides from “The Cardiac Eligible Patient” webinar, allowing staff to revisit and reinforce their understanding of hospice eligibility for cardiac patients. Heart Disease Hospice Indicator Flyers Theme: Simplifying Cardiac Eligibility Criteria • Pain Point: LTC staff often find it challenging to determine hospice eligibility for residents with heart disease. • Solution: Heart Disease Hospice Indicator Flyers that clearly outlines the criteria for hospice eligibility in cardiac patients, helping staff make informed decisions. Managing Your ESHF Patient Facing Theme: Supporting End-Stage Heart Failure Patients • Pain Point: LTC Staff need guidance on managing end-stage heart failure (ESHF) patients and communicating effectively with them and their families. • Solution: Resources and guidelines on managing ESHF patients, including communication strategies and care plans, to support staff in delivering high-quality care. Article: Perceived Social Isolation and Outcomes in Patients With Heart Failure - BAYADA Hospice Internal Staff Only Theme: Addressing Social Isolation in Heart Failure Patients • Pain Point: Heart failure patients often experience social isolation—even in the LTC Community—which can negatively impact their outcomes.

For BAYADA Sales Training Only Confidenal| 16 • Solution: The “Perceived Social Isolation and Outcomes in Patients With Heart Failure” is for internal staff education only and is offered to raise awareness and provide strategies for addressing social isolation in heart failure patients, improving their overall well-being and care outcomes

For BAYADA Sales Training Only Confidenal| 17 ‘Earlier is Better’ Email and Social Media Campaign EIB General Campaign Resources: Themes, Pain Points, and Solutions Earlier is the Better Hospice Sales Campaign Guide The guide provides a detailed roadmap for executing the “Earlier is Better” campaign, including strategies, messaging, and best practices to ensure successful outreach and engagement. EIB October 2, 2023, Rollout Webinar • The webinar offers an overview of the campaign, training on how to use the resources, and a Q&A session to address any concerns or questions, ensuring everyone is well-prepared. EIB Rollout Slides • The slides provide a visual and concise summary of the campaign, making it easier for staff to grasp and remember the essential points and strategies. MyEmma Email Platform • MyEmma offers a user-friendly platform with specific instructions and tips to help staff efficiently manage email campaigns, ensuring timely and effective communication. o Login Page for MyEmma  Provides a direct link to the login page, ensuring quick and easy access for staff. o Instructions for Uploading Email Audience  Detailed instructions help staff upload and organize their email audience, ensuring accurate and targeted communication. o Instructions for Naming, Customizing, and Sending an Email Template Campaign  Provides clear guidelines on how to name, customize, and send email templates, making the process straightforward and efficient. o Tips for the Best Days & Times to Send Email  Offers insights and tips on the best days and times to send emails, helping to increase open rates and engagement. EIB Resource Crosswalk • Theme: Coordination of EIB Resources with Messaging • Pain Point: Challenge with aligning various resources with the campaign messaging.

For BAYADA Sales Training Only Confidenal| 18 • Solution: The Crosswalk provides an easy way to coordinate EIB resources with the campaign messaging, ensuring consistency and effectiveness in communication. o The Crosswalk is an easy way to coordinate EIB resources with Messaging-JV Brands Included Earlier is Better: Internal Education and Access to All Resources Theme: Emphasizing the Benefits of Early Hospice Referrals Weeks 1-4: Quality Time with Those Most Important • Pain Point: Long-term care staff often struggle to communicate the benefits of early hospice care to patients and their families. • Solution: “Earlier is Better” highlights the importance of quality time with loved ones, emphasizing how early hospice care can enhance these precious moments. Weeks 5-8: The Value of Sooner is Better • Pain Point: Staff may not realize the clinical benefits of early hospice care for patients with chronic diseases. • Solution: “Earlier is Better” focuses on the improved outcomes and quality of life for patients who receive hospice care earlier in their disease process. Weeks 9-12: Disease-Specific Benefits of Early Hospice Referrals • Pain Point: Long-term care staff may not be aware of the specific benefits of early hospice care for different diseases. • Solution: “Earlier is Better” provides detailed information on how early hospice referrals can benefit patients with specific conditions. This campaign aims to educate and empower long-term care staff to make timely and appropriate hospice referrals, ultimately enhancing the quality of life for their patients.

For BAYADA Sales Training Only Confidenal| 19 Referral Source Training Resources Location: Hospice Playbook>Business Development>Campaigns & Collateral Introduction to Hospice Care Theme: Enhancing Understanding of Hospice Care • Pain Point: LTC staff often lack a clear understanding of hospice care and its benefits. • Solution: Provides comprehensive training sessions to educate staff on the principles and benefits of hospice care, ensuring they are well-informed. Common Hospice Misconceptions • Theme: Dispelling Myths About Hospice Care • Pain Point: Families and staff often have misconceptions about hospice care, leading to resistance and delays in providing appropriate end-of-life care. • Solution: Clarifies common misconceptions about hospice care, emphasizing its focus on quality of life, comfort, and comprehensive support for both patients and families.

For BAYADA Sales Training Only Confidenal| 20 Hospice Sales Training & Resources: Themes and Descriptions Location: Hospice Playbook>Business Development>Internal Training>Current Training and Resources DATA-DRIVEN SALES STRATEGIES Trella Marketscape-Resource Page • Theme: Leveraging Market Data for Sales Strategies • Description: The resource page provides detailed market insights and data to help sales teams make informed decisions and tailor their approaches effectively. Selling Data-Driven Value-Webinar • Theme: Utilizing Data to Enhance Sales Value • Description: The webinar teaches sales teams how to use data to highlight the benefits of hospice care, making their pitches more compelling and evidence based. Webinar Slides-Link • Theme: Visual Support for Data-Driven Sales Strategies • Description: The slides offer a visual summary of the webinar, making it easier for sales teams to review and implement the strategies discussed. HOSPICE DISCOVERY QUESTIONS Discovery Questions by Referral Source Type-Link • Theme: Tailored Discovery Questions for Different Referral Sources • Description: This resource provides specific discovery questions tailored to various referral sources, helping sales teams gather relevant information and build stronger relationships. HOSPICE 101 TOOLS Hospice Training Resource Manual-Link • Theme: Comprehensive Training Manual for Hospice Sales • Description: The manual offers a thorough guide to hospice sales, covering essential topics and best practices to ensure new staff are well-prepared. HOSPICE ELIGIBILITY RESOURCES Hospice Eligibility by Diagnosis Resource-Link • Theme: Understanding Eligibility Criteria by Diagnosis • Description: This resource provides detailed eligibility criteria for various diagnoses, helping staff make accurate and timely hospice referrals.

For BAYADA Sales Training Only Confidenal| 21 General Eligibility The Hospice Eligible Patient Part One (Neurological Diseases)- Webinar • Theme: Identifying Hospice Eligibility for Neurological Diseases • Description: The webinar covers the signs and criteria for hospice eligibility in neurological patients, aiding staff in making appropriate referrals. Hospice Eligible Patient (Part One) Slides-Link • Theme: Visual Aid for Neurological Eligibility Criteria • Description: The slides provide a visual summary of the webinar, making it easier to review and apply the information. The Hospice Eligible Patient Part Two (Cancer & Non-Cancer Diseases) –Link • Theme: Identifying Hospice Eligibility for Cancer and Non-Cancer Diseases • Description: The webinar covers the signs and criteria for hospice eligibility in these patients, aiding staff in making appropriate referrals. Hospice Eligible Patient (Part Two) Slides – Link • Theme: Visual Aid for Cancer and Non-Cancer Eligibility Criteria • Description: The slides provide a visual summary of the webinar, making it easier to review and apply the information. Cardiac Related Eligibility The Cardiac Eligible Hospice Patient Webinar and Resources-Link • Theme: Identifying Hospice Eligibility for Cardiac Patients • Description: The webinar and resources cover the signs and criteria for hospice eligibility in cardiac patients, aiding staff in making appropriate referrals. MINI SALES BOOT CAMP HOSPICE TRAINING Hospice 101 Webinar-Hospice 101-Mini Sales Boot Camp-Basic • Theme: Basic Training for Hospice Sales • Description: The webinar provides basic training, covering essential topics to ensure new staff are well-prepared. Webinar Slides-Link • Theme: Visual Aid for Basic Hospice Sales Training • Description: The slides provide a visual summary of the webinar, making it easier to review and apply the information.

For BAYADA Sales Training Only Confidenal| 22 Resource-Hospice Service Office Profile Tool • Theme: Tool for Profiling Hospice Service Offices • Description: The tool helps sales staff profile hospice service offices, aiding in better understanding and communication. Hospice 101-Handling Hospice Objections Webinar: Handling Hospice Objections • Theme: Training on Handling Objections in Hospice Sales • Description: The webinar provides strategies and techniques for effectively handling objections, improving sales outcomes. Webinar Slides: Link • Theme: Visual Aid for Handling Objections Training • Description: The slides provide a visual summary of the webinar, making it easier to review and apply the information. Hospice 101-Palliative Care Sales Training Webinar-Hospice 101-Palliative Care Sales Training Webinar • Theme: Training on Palliative Care Sales • Description: The webinar provides comprehensive training on palliative care sales, ensuring staff are well-equipped to handle this aspect of hospice care. Webinar Slides-Link • Theme: Visual Aid for Palliative Care Sales Training • Description: The slides provide a visual summary of the webinar, making it easier to review and apply the information. The Hospice Referral Checklist & Patient and Family Meeting Training The Hospice Referral Intake Checklist Webinar • Theme: Training on Hospice Referral Intake • Description: The webinar provides detailed training on the intake process, ensuring staff can handle referrals efficiently and accurately. The Patient and Family Meeting Webinar • Theme: Training on Conducting Patient and Family Meetings • Description: The webinar offers strategies and best practices for conducting these meetings, improving communication and outcomes. Slides for both Webinars-Link • Theme: Visual Aid for Referral Intake and Patient Meeting Training

For BAYADA Sales Training Only Confidenal| 23 • Description: The slides provide a visual summary of both webinars, making it easier to review and apply the information. Resource-Hospice Referral Intake Checklist-All Brands • Theme: Comprehensive Checklist for Hospice Referral Intake • Description: The checklist provides a standardized approach to referral intake, ensuring consistency and accuracy across all brands. Resource-Patient and Family Meeting Tip Sheet • Theme: Tips for Effective Patient and Family Meetings • Description: The tip sheet offers practical advice and strategies for improving these meetings, enhancing communication and outcomes. Hospice Office Profile Tool-editable 3.23 • Theme: Editable Tool for Profiling Hospice Offices • Description: The editable tool allows staff to customize profiles for different hospice offices, aiding in better understanding and communication.

For BAYADA Sales Training Only Confidenal| 24 BAYADA Hospice Business Development Playbook The Value of Hospice in the Long-Term Care Facility

For BAYADA Sales Training Only Confidenal| 25 Introduction This playbook is designed to help BAYADA Hospice business development professionals effectively engage with long-term care (LTC) facilities. By understanding the unique needs and challenges of each key decision maker within the facility, you can tailor your approach to provide hospice solutions that resonate and build strong referral relationships. Getting to Know the Key Decision Makers In a long-term care (LTC) facility, the typical decision makers for selecting a hospice agency could include the following: 1. Administrator • Responsibilities: Overseeing facility operations, non-nursing staff, budgets, hiring, census, and contracts. • What They Look For: o Financial Impact: Cost savings, reimbursement rates, and overall financial benefits. o Regulatory Compliance: How the hospice agency helps meet CMS quality measures and regulatory requirements. o Reputation and Reliability: Track record of the hospice agency and feedback from other facilities. 2. Director of Nursing (DON) • Responsibilities: Overseeing nursing supervisors and staff, patient care, and survey preparations. • What They Look For: o Quality of Care: Clinical outcomes, pain and symptom management, and patient satisfaction. o Staff Support and Training: Education and support provided to nursing staff. o Integration with Facility Operations: How seamlessly the hospice services integrate with existing care processes. 3. Nursing Supervisors • Responsibilities: Overseeing charge nurses, providing patient care, and liaising between family, patient, staff, and vendors. • What They Look For:

For BAYADA Sales Training Only Confidenal| 26 o Patient Care Quality: Effectiveness of pain and symptom management. o Communication and Coordination: How well the hospice team communicates with facility staff and families. o Support for Staff: Training and resources provided to nursing staff. 4. Social Service Designees / Directors of Social Service • Responsibilities: Accommodating patients’ social needs, communicating with families, scheduling care plan meetings, and referring to hospice. • What They Look For: o Emotional and Spiritual Support: Counseling and support services for patients and families. o Ease of Referral Process: How straightforward and supportive the hospice referral process is. o Family Feedback: Positive experiences and testimonials from families. 6. Director of Staff Development (DSD) • Responsibilities: Managing certified nursing assistants, hiring, education, and scheduling in-services. • What They Look For: o Training Programs: Availability and quality of hospice education and training for staff. o Support for Staff: Resources and support provided to enhance staff skills in end-of-life care. o Feedback from Staff: Positive experiences and testimonials from staff who have worked with the hospice agency. 7. MDS Coordinator • Responsibilities: Managing Medicare skilled patients, reviewing charts, ensuring documentation for CMS, and determining service needs. • What They Look For: o Documentation and Compliance: Support for accurate documentation and compliance with CMS requirements. o Medicare Eligibility: Clear criteria and support for identifying eligible patients. o Successful Transitions: Case studies and examples of successful transitions from skilled care to hospice.

For BAYADA Sales Training Only Confidenal| 27 8. Admissions Team • Responsibilities: New patient admissions and marketing. • What They Look For: o Marketing Support: Materials and support for promoting hospice services to prospective residents and families. o Referral Advocacy: How the hospice agency supports the admissions team in advocating for their services. o Family Testimonials: Positive feedback and testimonials from families. 9. Business Office Manager • Responsibilities: Handling financials, managing contracts, overseeing care levels and reimbursement. • What They Look For: o Financial Impact: Cost savings and financial benefits of partnering with the hospice agency. o Contract Management: Clear and favorable contract terms. o Reimbursement Rates: Understanding of and support for managing reimbursement rates. By understanding the specific needs and decision-making criteria of each role, BAYADA Hospice business development professionals can tailor their approach to effectively communicate the value of their services and build strong referral relationships. Importance of Account Profiling and Needs Discovery Account profiling and needs discovery are critical steps in providing hospice solutions that resonate with each role within the LTC facility. By understanding the specific needs, pain points, and goals of each decision maker, you can tailor your approach to demonstrate how BAYADA Hospice can address their unique challenges and improve overall care quality.

For BAYADA Sales Training Only Confidenal| 28 Open-Ended Discovery Questions Administrator 1. What are your primary goals for the facility this year? 2. How do you currently evaluate the success of your partnerships with external care providers? 3. What challenges do you face in managing the facility’s budget and resources? 4. How do you decide which hospice agency to partner with? 5. Can you share any recent experiences with hospice care in your facility? Director of Nursing (DON) 1. What are the biggest challenges you face in ensuring high-quality patient care? 2. How do you prepare for state and federal surveys? 3. What criteria do you use to approve hospice agencies for your facility? 4. How do you manage the integration of hospice care with your nursing staff? 5. Can you describe a successful hospice partnership you’ve had in the past? Nursing Supervisors 1. What are the most common issues you encounter with patient care? 2. How do you coordinate care between families, patients, and staff? 3. What role do you play in selecting hospice agencies for your facility? 4. How do you ensure that patients receive the best possible end-of-life care? 5. Can you share any feedback you’ve received from families about hospice care? Social Service Designees / Directors of Social Service 1. How do you identify patients who might benefit from hospice care? 2. What are the main concerns families have about hospice services? 3. How do you coordinate care plan meetings and ensure all needs are met? 4. What resources do you need to better support your patients’ social needs? 5. Can you describe a situation where hospice care significantly improved a patient’s quality of life? Director of Staff Development (DSD) 1. What are the key training needs for your certified nursing assistants? 2. How do you ensure your staff is prepared to provide end-of-life care?

For BAYADA Sales Training Only Confidenal| 29 3. What role does hospice education play in your training programs? 4. How do you schedule and manage in-service training sessions? 5. Can you share any success stories from your staff’s interactions with hospice care? MDS Coordinator 1. How do you manage the documentation and review process for Medicare patients? 2. What criteria do you use to determine when a patient no longer qualifies for skilled days? 3. How do you identify patients who might benefit from hospice care? 4. What challenges do you face in coordinating care for Medicare patients? 5. Can you describe a successful transition from skilled care to hospice? Admissions Team 1. How do you handle new patient admissions and ensure a smooth transition? 2. What role do you play in recommending hospice services to new admits? 3. How do you communicate the benefits of hospice care to families? 4. What feedback have you received from families about their hospice experience? 5. Can you share any examples of successful hospice referrals? Business Office Manager 1. How do you manage the financial aspects of hospice partnerships? 2. What challenges do you face in handling contracts and reimbursements? 3. How do you evaluate the financial impact of hospice care on the facility? 4. What criteria do you use to select hospice agencies for partnerships? 5. Can you share any insights on how hospice care has affected your facility’s financial performance? Additional Discovery Questions Qualifying Questions 1. How many licensed beds does your facility have? How many beds are Medicare certified? 2. How many residents do you have in long-term care? 3. How many skilled patients are discharged to hospice in a typical month? 4. Are any of your Medical Directors or attending physicians affiliated with hospice providers?

For BAYADA Sales Training Only Confidenal| 30 5. Who decides which hospice providers to use? 6. Who are you currently using for hospice services? 7. How often do you make a referral to hospice in a typical week? 8. Do you have any respite care contracts with hospice providers? 9. What day of the week are your care plan meetings? 10. What day of the week are your Medicare meetings? Discovery Questions: Uncovering Needs 1. What is most important to you when working with a hospice provider? 2. How does your team identify residents who might be eligible for hospice care? 3. What are your expectations when working with a hospice provider? 4. What diagnoses are most challenging for you to treat? Why? 5. What aspects of [disease state] have the greatest impact on your staff? 6. How can our hospice company exceed your expectations of hospice care? 7. What are your primary concerns day to day when referring patients to hospice? 8. What challenges have you had in the past when working with hospice providers? 9. What is your process for determining when your resident may need hospice care? 10. What is your process for making hospice referrals? 11. How do you prefer to utilize a hospice agency to provide information to a patient/family once you identify a hospice need or make a hospice referral? 12. What is your understanding of hospice services? 13. What is your understanding of hospice eligibility? 14. What benefits do you feel hospice services provide to your facility and your patients/families? 15. What are your greatest challenges when caring for complex patients? What resources do you provide them? At what point in their care do you provide these resources? 16. Tell me about your experience with terminally ill patients. 17. Tell me about your residents who spend most of their time in bed or confined to a wheelchair. 18. Tell me about your residents who continue to lose weight regardless of safety nets in place.

For BAYADA Sales Training Only Confidenal| 31 19. Tell me about patients who have had recent hospitalizations, frequent infections/pneumonia. 20. Tell me about your patients who have suffered multiple falls. 21. What resources do you provide your patients when they decline aggressive treatment? 22. Tell me about your patients that you wouldn’t be surprised if they passed away in 6 months. 23. Tell me about when you have your end-of-life conversations. How comfortable are you? 24. Describe your best scenario for end-of-life. What would make it easier for you, your patients, and your staff? Using Stories and Case Studies in Business Development Using stories and case studies to sell hospice services offers several compelling benefits: 1. Emotional Connection Stories and case studies create an emotional connection with the audience. They humanize the services provided, making it easier for potential clients and partners to relate to the experiences of patients and families. This emotional engagement can be a powerful motivator for decision-making. 2. Illustrating Value Case studies provide concrete examples of how hospice care improves the quality of life for patients and supports their families. They highlight the comprehensive benefits, such as pain and symptom management, emotional and spiritual support, and coordinated care. This helps illustrate the value proposition of hospice services in a clear and relatable way. 3. Building Trust Sharing real-life or well-crafted fictional stories builds trust with the audience. It shows that the hospice provider has a track record of delivering compassionate and effective care. Trust is crucial in healthcare decisions, and stories can help establish credibility and reliability. 4. Demonstrating Outcomes Case studies can showcase specific outcomes, such as reduced hospitalizations, improved patient comfort, and higher family satisfaction. These data-driven insights provide evidence of the effectiveness of hospice care, making a strong case for its benefits.

For BAYADA Sales Training Only Confidenal| 32 5. Educational Tool Stories and case studies serve as educational tools for both potential clients and business development specialists. They help explain complex concepts in an accessible way and provide a framework for understanding the full scope of hospice services. For business development specialists, they offer insights into creating effective sales strategies and precall plans. 6. Highlighting Unique Features Case studies can highlight unique features of the hospice provider, such as the use of advanced technology like Muse for predictive care planning. This differentiation can set the provider apart from competitors and emphasize the added value they bring. 7. Versatility Stories and case studies can be adapted for various audiences, including healthcare providers, policymakers, and potential clients. They can be tailored to address the specific concerns and interests of each group, making them a versatile tool in business development. 8. Encouraging Action By presenting relatable scenarios and positive outcomes, stories and case studies can encourage potential clients and partners to take action. They can see the tangible benefits of hospice care and feel more confident in making decisions about end-of-life care. In summary, using stories and case studies to sell hospice services leverages the power of narrative to create emotional connections, build trust, and demonstrate value. They are effective tools for illustrating the comprehensive benefits of hospice care and supporting business development efforts Example: Case Study 1: Positive Outcome for the LTC Facility Background A 150-bed LTC facility was experiencing high hospitalization rates among its residents with advanced chronic illnesses, leading to significant revenue loss and regulatory challenges. Intervention BAYADA Hospice partnered with the facility to provide comprehensive hospice services, including pain and symptom management, emotional support, and staff training. Outcome Within six months, the facility saw a 40% reduction in hospitalizations, saving approximately $18,000 in annualized revenue. The partnership also improved compliance with CMS quality measures, enhancing the facility’s reputation and operational efficiency. References

For BAYADA Sales Training Only Confidenal| 33 1. Reduction in Hospitalizations: Studies have shown that integrating hospice care into nursing homes can significantly reduce hospitalizations. For example, the INTERACT program reduced hospital admissions by 17%1, and the Evercare model reduced hospital admissions by 47%1. 2. Economic Value: Evidence on the economic value of palliative care interventions indicates substantial savings to the health system, including decreased total healthcare costs and improved patient outcomes2. 3. Improved Compliance and Quality Measures: Implementing hospice services can lead to better compliance with CMS quality measures, as seen in various initiatives supported by the US Centers for Medicare and Medicaid Services3. These references support the positive outcomes observed in the case study, demonstrating the significant benefits of integrating hospice care into long-term care facilities. 1: CMS Webinar on Reducing Hospitalizations 2: BMC Palliative Care 3: BMJ Quality & Safety Example: Case Study 2: Positive Outcome for the Resident and Family (With Data References) Background Resident: Mary Johnson, an 85-year-old female with advanced Alzheimer’s disease and congestive heart failure (CHF). Current Status: Mary has been a resident at the LTC facility for 2 years. Over the past 6 months, her condition has deteriorated, with increased confusion, frequent hospitalizations, and significant weight loss. Alzheimer’s disease affects approximately 6.2 million Americans aged 65 and older, with the number expected to double by 2050. CHF is a common comorbidity in elderly patients with Alzheimer’s, increasing the complexity of care. Intervention BAYADA Hospice was introduced to provide comprehensive end-of-life care, including: • Pain and Symptom Management: Regular visits from hospice nurses to manage pain and other distressing symptoms. Data from the National Institute on Aging shows that effective pain management significantly improves quality of life in Alzheimer’s patients. • Emotional and Spiritual Support: Counseling services for Mary and her family to help them cope with the emotional aspects of her illness. Family satisfaction scores collected by BAYADA Hospice indicate high levels of appreciation for these services. • Nutritional Support: Collaboration with the facility’s dietary team to ensure Mary received appropriate nutrition. Nutritional data analysis helps in monitoring and adjusting dietary plans to prevent further weight loss.

For BAYADA Sales Training Only Confidenal| 34 • Advanced Technology - Muse: BAYADA utilizes Muse, an industry-leading technology, to deliver precise care planning. This technology allows the care team to: o Anticipate, with 90% accuracy, the approaching last days of life, enabling real-time adjustments to care plans. o Increase the number and quality of RN and MSW visits in the last days of life. o Anticipate patient needs to deliver timely interventions and support. o Increase the amount of time at the patient’s bedside during the last days of life, improving quality of care through better symptom management and psychosocial/emotional support for patients and loved ones. BAYADA Hospice patients received 71% more visits at the end of life than the national average. Outcome • Resident: Mary experienced significant relief from pain and discomfort, leading to improved quality of life in her final months. Her symptoms were better managed, and she was able to remain comfortable. Predictive models can help identify patients at high risk of hospitalization due to CHF and Alzheimer’s, allowing for timely interventions. • Family: Mary’s family felt supported and informed throughout the process. They appreciated the regular updates, and the compassionate care provided by the hospice team, which helped them navigate this difficult time. Feedback from family members is crucial in measuring the impact of emotional and spiritual support. • Staff: The LTC facility staff benefited from the additional support and training provided by BAYADA Hospice, which improved their ability to care for Mary and other residents with similar needs. Evaluating the impact of training on staff performance and resident outcomes can highlight areas for further education and support. Incorporating these data-driven insights provides a more comprehensive understanding of Mary’s care and helps improve outcomes for similar cases. Alzheimer’s Association. (2021). Alzheimer’s Disease Facts and Figures. Johns Hopkins Medicine. (2024). Dementia and Heart Health: Are They Related?. Alzheimer’s.gov. (2024). Could AI learn to spot warning signs of Alzheimer’s disease from electronic health records?. National Institute on Aging. (2023). Pain Management in Alzheimer’s Disease. BAYADA Hospice. (2024). Family Satisfaction Survey Results. American Heart Association. (2023). Nutritional Guidelines for Heart Failure Patients. BAYADA Hospice. (2024).

For BAYADA Sales Training Only Confidenal| 35 Example: Case Study 3: Positive Outcome for the Resident, Family, and Staff Background Resident: John Davis, a 90-year-old male with terminal lung cancer and chronic obstructive pulmonary disease (COPD). Current Status: John has been a resident at the LTC facility for 1 year. His condition has worsened over the past 3 months, with increased pain, difficulty breathing, and frequent infections. Lung cancer is one of the leading causes of cancer death worldwide, and COPD is a common comorbidity that complicates treatment and care. Intervention BAYADA Hospice was brought in to provide specialized palliative care, including: • Pain and Symptom Management: Hospice nurses provided regular pain management and respiratory support to alleviate John’s symptoms. Data from the National Institute on Aging shows that effective pain management significantly improves quality of life in terminally ill patients. • Emotional and Spiritual Support: Hospice counselors offered emotional support to John and his family, addressing their fears and concerns. Early involvement of the spiritual care coordinator provided additional support, allowing the family to focus on being present with John during his final days. Family satisfaction scores collected by BAYADA Hospice indicate high levels of appreciation for these services. • Coordination of Care: The hospice team worked closely with the LTC facility staff to ensure seamless care coordination and communication. • Advanced Technology - Muse: BAYADA utilizes Muse, an industry-leading technology, to deliver precise care planning. This technology allows the care team to: o Anticipate, with 90% accuracy, the approaching last days of life, enabling real-time adjustments to care plans. o Increase the number and quality of RN and MSW visits in the last days of life. o Anticipate patient needs to deliver timely interventions and support. o Increase the amount of time at the patient’s bedside during the last days of life, improving quality of care through better symptom management and psychosocial/emotional support for patients and loved ones. BAYADA Hospice patients received 71% more visits at the end of life than the national average. Outcome • Resident: John experienced significant pain relief and improved symptom management, allowing him to spend his final days in comfort and dignity. Predictive models can help

For BAYADA Sales Training Only Confidenal| 36 identify patients at high risk of hospitalization due to COPD and lung cancer, allowing for timely interventions. John and his family particularly appreciated the increased visits in his last few days, which were made possible by the Muse predictive tool. This additional support provided comfort and reassurance during a challenging time. • Family: John’s family received continuous support and guidance from the hospice team, which helped them feel more at ease and prepared for his passing. They expressed gratitude for the compassionate care provided. The early involvement of the spiritual care coordinator allowed the family to truly be present with John, enhancing their ability to cherish their final moments together. Feedback from family members is crucial in measuring the impact of emotional and spiritual support. • Staff: The LTC facility staff received additional training and support from BAYADA Hospice, enhancing their skills in providing end-of-life care. This collaboration also reduced staff stress and burnout, as they felt more equipped to handle complex cases. Evaluating the impact of training on staff performance and resident outcomes can highlight areas for further education and support. These case studies illustrate the comprehensive benefits of integrating BAYADA Hospice services into long-term care facilities, highlighting the positive impact on residents, their families, and the facility staff. American Cancer Society. (2024). Lung Cancer. National Institute on Aging. (2023). Pain Management in Alzheimer’s Disease. BAYADA Hospice. (2024). Family Satisfaction Survey Results. Alzheimer’s.gov. (2024). Could AI learn to spot warning signs of Alzheimer’s disease from electronic health records?. BAYADA Hospice.

For BAYADA Sales Training Only Confidenal| 37 The Business End Hospice agencies can help long-term care (LTC) facilities generate additional revenue in several ways: 1. Reducing Hospitalizations Hospice care can significantly reduce the number of hospitalizations for residents with advanced illnesses. By managing symptoms effectively within the facility, hospice care minimizes the need for costly hospital transfers. This reduction in hospitalizations can save the facility substantial amounts of money. For example, a study found that integrating hospice care into nursing homes can reduce hospital admissions by up to 47%1. 2. Improving Reimbursement Rates Hospice care can improve the facility’s overall reimbursement rates by ensuring that residents receive appropriate end-of-life care. This can lead to better compliance with CMS quality measures, which can positively impact the facility’s reimbursement rates. Facilities that demonstrate high-quality care and compliance with regulations are often eligible for higher reimbursement rates from Medicare and other payers2. 3. Enhancing Occupancy Rates By providing hospice care, LTC facilities can attract more residents who require end-of-life care. Families often prefer facilities that offer comprehensive hospice services, knowing that their loved ones will receive compassionate and specialized care. This can lead to higher occupancy rates and increased revenue from room and board fees3. 4. Reducing Bed Hold Costs Hospice care can help reduce the costs associated with holding beds for hospitalized residents. For example, if a facility has a 200-bed capacity and 5% of residents are appropriate for hospice care, reducing hospitalizations can save significant revenue. Assuming a $150 room rate and a 5-day hospital stay, the facility could save $27,000 annually by reducing hospitalizations for just three residents per month4. 5. Providing Additional Services Hospice agencies often offer additional services such as palliative care, bereavement support, and staff training. These services can enhance the overall quality of care provided by the facility, making it more attractive to potential residents and their families. This can lead to increased referrals and higher occupancy rates5. 6. Enhancing Staff Efficiency Hospice care can alleviate some of the burdens on LTC facility staff by providing specialized end-of-life care. This allows the facility’s nursing staff to focus on other residents, improving

For BAYADA Sales Training Only Confidenal| 38 overall efficiency and care quality. Enhanced staff efficiency can lead to better patient outcomes and higher satisfaction rates, which can positively impact the facility’s reputation and revenue. By integrating hospice services, LTC facilities can not only improve the quality of care for their residents but also enhance their financial performance through reduced hospitalizations, improved reimbursement rates, and increased occupancy. 1: CMS Webinar on Reducing Hospitalizations 2: BMC Palliative Care 3: BMJ Quality & Safety 4: NHPCO Palliative Care Playbook 5: Hospice News : American Journal of Hospice and 7. Home Health and Hospice Collaboration Home care and Hospice agencies can make referrals to long-term care (LTC) facilities. This collaboration can be beneficial for several reasons: 1. Continuity of Care: When a patient receiving hospice or home care services requires a higher level of care, such as that provided in an LTC facility, the hospice or home care agency can facilitate a smooth transition. This ensures that the patient continues to receive appropriate care without interruption1. 2. Specialized Care Needs: Patients with complex medical needs or those who require round-the-clock supervision may benefit from the specialized services available in LTC facilities. Hospice and home care agencies can identify these needs and refer patients accordingly2. 3. Resource Optimization: By referring patients to LTC facilities when necessary, hospice and home care agencies can optimize their resources and focus on providing in-home care to other patients who can benefit from it3. 4. Collaborative Relationships: Establishing referral relationships between hospice/home care agencies and LTC facilities fosters collaboration and ensures that patients receive the best possible care tailored to their needs4. Hospice and Long Term Care Facility Collaboration Working with a long-term care (LTC) facility that is Medicare and Medicaid approved for both LTC and skilled nursing to provide an additional level of hospice care can offer numerous benefits. Here’s how this collaboration can be advantageous:

For BAYADA Sales Training Only Confidenal| 39 Benefits of Collaboration 1. Enhanced Continuity of Care o Seamless Transitions: Patients can transition smoothly from skilled nursing to hospice care without needing to move to a different facility, ensuring continuity of care and reducing stress for patients and families1. 2. Comprehensive Care o Holistic Approach: Combining skilled nursing and hospice care allows for a holistic approach to patient care, addressing both medical and palliative needs. This ensures that patients receive comprehensive care tailored to their specific conditions2. 3. Improved Patient Outcomes o Symptom Management: Hospice care provides specialized symptom management, which can significantly improve the quality of life for residents with terminal illnesses3. o Reduced Hospitalizations: Effective hospice care can reduce the need for hospitalizations, which is beneficial for both the patient and the facility in terms of cost and care continuity4. 4. Financial Benefits o Increased Revenue: By reducing hospitalizations and improving care quality, the facility can see financial benefits through better reimbursement rates and reduced bed hold costs. o Medicare and Medicaid Reimbursements: Facilities that are certified for both Medicare and Medicaid can maximize their reimbursement opportunities by providing a full spectrum of care services. 5. Regulatory Compliance o Meeting Quality Measures: Integrating hospice care helps facilities meet CMS quality measures, which can improve their ratings and compliance with federal and state regulations. Collaboration Strategies 1. Establish Clear Communication Channels o Regular Meetings: Hold regular interdisciplinary team meetings to discuss patient care plans and ensure all team members are aligned. o Care Coordination: Designate care coordinators to manage the transition between skilled nursing and hospice care.

For BAYADA Sales Training Only Confidenal| 40 2. Training and Education o Staff Training: Provide ongoing training for facility staff on hospice care principles and practices to ensure they are well-equipped to support hospice patients. o Family Education: Offer educational sessions for families to help them understand the benefits of hospice care and what to expect. 3. Collaborative Care Plans o Integrated Care Plans: Develop integrated care plans that include both skilled nursing and hospice care components, ensuring a seamless approach to patient care. o Personalized Care: Tailor care plans to meet the individual needs of each patient, considering both their medical and palliative care requirements. 4. Utilize Data and Feedback o Monitor Outcomes: Use data to monitor patient outcomes and adjust care plans as needed to ensure the highest quality of care. o Gather Feedback: Collect feedback from patients, families, and staff to continuously improve the hospice care services provided. By leveraging the strengths of both skilled nursing and hospice care, LTC facilities can provide a higher level of care that benefits patients, families, and the facility itself. 1: Medicaid Nursing Facilities 2: CMS Minimum Staffing Standards 3: National Institute on Aging 4:

For BAYADA Sales Training Only Confidenal| 41 Hospice Levels of care in the Long Term Care Facility Hospice agencies can collaborate with long-term care (LTC) facilities to provide respite care, routine care, and inpatient care by adhering to the Medicare Hospice Conditions of Participation (CoPs). Here’s how they can work together effectively: 1. Respite Care Definition: Respite care provides temporary relief for primary caregivers by admitting the patient to an inpatient facility for up to five consecutive days. Collaboration Steps: • Contractual Agreements: Establish contracts between the hospice agency and the LTC facility to provide respite care services. • Care Coordination: Ensure seamless communication between hospice and LTC staff to coordinate the patient’s care plan during the respite period. • Compliance: Adhere to Medicare regulations, ensuring that respite care is provided in a Medicare-certified facility and that the patient’s care needs are met during their stay1. 2. Routine Home Care Definition: Routine home care is the most common level of hospice care, provided wherever the patient resides, including LTC facilities. Collaboration Steps: • Integrated Care Plans: Develop integrated care plans that include both hospice and LTC services, ensuring that all aspects of the patient’s care are addressed. • Regular Visits: Hospice staff, including nurses, social workers, and aides, make regular visits to the LTC facility to provide care and support. • Training and Support: Provide training for LTC staff on hospice care principles and practices to ensure they are well-equipped to support hospice patients2. 3. General Inpatient Care Definition: General inpatient care is provided for pain control or acute symptom management that cannot be managed in other settings. Collaboration Steps: • Facility Requirements: Ensure that the LTC facility meets the requirements to provide general inpatient care, including having the necessary staff and equipment.

For BAYADA Sales Training Only Confidenal| 42 • Contractual Agreements: Establish contracts with Medicare-certified hospitals or skilled nursing facilities if the LTC facility does not have the capability to provide inpatient care directly. • Care Coordination: Maintain close communication between hospice and LTC staff to manage the patient’s care plan and ensure that all medical and palliative needs are met3. Key Considerations for Collaboration • Regulatory Compliance: Both hospice and LTC facilities must comply with Medicare regulations, including the Conditions of Participation (42 CFR 418), to ensure that all services are provided according to federal standards4. • Interdisciplinary Team Meetings: Regular interdisciplinary team meetings should be held to discuss patient care plans, coordinate services, and address any issues that arise. • Documentation and Reporting: Accurate documentation and reporting are essential to ensure compliance with Medicare requirements and to provide high-quality care. By following these steps, hospice agencies and LTC facilities can work together to provide comprehensive, high-quality care that meets the needs of patients and their families. Would you like more details on any specific aspect of this collaboration or additional strategies for implementation? 1: CMS Hospice Conditions of Participation 2: Verywell Health on Levels of Hospice Care 3: NHPCO General Inpatient Care Compliance Guide 4: Medicare Hospice Regulations Don’t forget the Legal Stuff Hospice agencies need to have a contract with the long-term care (LTC) facility to provide the various levels of hospice services. This requirement ensures that both parties clearly understand their roles, responsibilities, and the scope of services provided. Here are some key points regarding these contracts: 1. Regulatory Requirement: According to the Centers for Medicare & Medicaid Services (CMS), a written agreement is required between the hospice agency and the LTC facility. This contract outlines the responsibilities of each party and ensures compliance with Medicare regulations1. 2. Scope of Services: The contract specifies the levels of hospice care to be provided, including routine home care, respite care, and general inpatient care. It ensures that the

For BAYADA Sales Training Only Confidenal| 43 LTC facility can meet the needs of hospice patients and that the hospice agency maintains professional, financial, and administrative responsibility for the services2. 3. Coordination of Care: The contract facilitates seamless coordination between the hospice agency and the LTC facility, ensuring that patient care plans are integrated and that there is clear communication between the teams3. 4. Compliance and Quality Assurance: The contract helps both the hospice agency and the LTC facility comply with Medicare Hospice Conditions of Participation (CoPs) and other regulatory requirements, ensuring high-quality care for patients4. By having a formal contract in place, hospice agencies and LTC facilities can work together effectively to provide comprehensive, high-quality care to residents. 1: CMS Finalizes Contract Requirements 2: CMS Hospice Conditions of Participation 3: Long-Term Facility-Hospice Agency Contracts 4: NHPCO Hospice Regulations How Hospice is Billed in the LTC Hospice care is typically covered by Medicare Part A, Medicaid, and many private insurance plans. This means that the costs associated with hospice care, including medications, medical equipment, and professional services, are covered, reducing the financial burden on the LTC facility. By integrating hospice services, LTC facilities can not only improve the quality of care for their residents but also enhance their financial performance through reduced hospitalizations, improved reimbursement rates, and increased occupancy. When a resident in a long-term care (LTC) facility transitions to hospice services, the billing for room and board is handled differently compared to standard care. Here’s how it typically works: Billing Process for Room and Board 1. Hospice Provider Agreement o The hospice provider and the LTC facility must have a contractual agreement in place. This agreement outlines the responsibilities of each party, including the billing and payment processes for room and board1. 2. Medicare and Medicaid Coverage o Medicare: Medicare covers hospice care services but does not pay for room and board in an LTC facility. The hospice provider bills Medicare for the hospice services provided, such as nursing care, medical equipment, and medications2.

For BAYADA Sales Training Only Confidenal| 44 o Medicaid: For residents who are dual-eligible (Medicare and Medicaid), Medicaid may cover the room and board costs. The hospice provider bills Medicaid for these costs, typically at 95% of the LTC facility’s rate1. 3. Billing by the Hospice Provider (Pass-Through) o The hospice provider is responsible for billing and receiving payment for the room and board charges. They bill the resident or their family for the room and board costs if not covered by Medicaid1. 4. Facility’s Role o The LTC facility continues to provide the room and board services and collaborates with the hospice provider to ensure seamless care for the resident. The facility receives payment for room and board from the hospice provider, based on the agreed-upon rate in the contract1. 2: CMS Hospice Conditions of Participation 1: Medi-Cal Room and Board Billing Without Pass-Through Billing When a state does not have a Medicaid pass-through option for hospice room and board, the billing process differs slightly. Here’s how it typically works: Billing Process for Room and Board Without a Pass-Through Option 1. Direct Billing to the Resident or Family o Hospice Services: The hospice provider bills Medicare for hospice services such as nursing care, medical equipment, and medications. o Room and Board: The LTC facility bills the resident or their family directly for room and board charges. Since there is no pass-through mechanism, the hospice provider does not act as an intermediary for these costs1. 2. Medicaid Coverage o Medicaid-Eligible Residents: For residents who are eligible for Medicaid, the LTC facility can bill Medicaid directly for room and board. The facility must ensure that it meets all state-specific Medicaid requirements for billing2. 3. Private Pay o Non-Medicaid Residents: For residents who are not eligible for Medicaid, the room and board costs are typically covered by private pay. The LTC facility bills the resident or their family directly for these charges3.

For BAYADA Sales Training Only Confidenal| 45 Key Considerations • Contractual Agreements: Even without a pass-through option, it’s important for the hospice provider and the LTC facility to have a clear contractual agreement outlining the responsibilities and billing processes. • Communication: Effective communication between the hospice provider, LTC facility, and the resident’s family is crucial to ensure that everyone understands the billing process and responsibilities. • Compliance: Both the hospice provider and the LTC facility must comply with all relevant state and federal regulations regarding billing and reimbursement. By understanding and managing the billing process effectively, LTC facilities and hospice providers can ensure that residents receive the necessary care while maintaining financial stability. 1: NGS Medicare - Starting the Hospice Billing Process 2: Iowa Department of Human Services - Medicaid Room and Board Billing 3: Hospice Tools - Medicaid Room & Board Pass-Through Billing Solutions

For BAYADA Sales Training Only Confidenal| 46 Best Practice for Hospice Business Development: Sales Strategy and Sales Call Step-by-Step Guidelines Using the BAYADA Six-Step Sales Process 1. Engage (Learn about the Industry and the Account) • Research the Industry: Understand the current trends, challenges, and opportunities in the hospice and long-term care (LTC) industry. Stay updated on regulatory changes, Medicare and Medicaid policies, and best practices in hospice care. • Profile the Account: Gather detailed information about the LTC facility, including the number of licensed beds, Medicare certification, current hospice providers, and key decision makers. Use qualifying questions to understand their specific needs and challenges. • Note: Please review the section on how the long-term care facility assess for care planning. 2. Listen (Discovery) • Conduct Discovery Meetings: Schedule meetings with key decision makers such as the Administrator, Director of Nursing, Social Service Designees, and MDS Coordinator. • Ask Open-Ended Questions: Use discovery questions to uncover the facility’s needs, pain points, and expectations. Examples include: o What is most important to you when working with a hospice provider? o How does your team identify residents who might be eligible for hospice care? o What challenges have you had in the past when working with hospice providers? 3. Frame (Clarification and Agreement of Primary Account Need) • Summarize Key Points: After gathering information, summarize the primary needs and challenges identified during the discovery phase. • Clarify and Confirm: Ensure that all parties agree on the primary needs and challenges. Use statements like, “From our discussion, it seems that reducing hospitalizations and improving pain management are your top priorities. Is that correct?” 4. Envision (Solution Crafting) • Craft Tailored Solutions: Based on the identified needs, develop customized solutions that BAYADA Hospice can offer. Highlight how these solutions address the specific challenges of the LTC facility. • Present Value Propositions: Use data and case studies to demonstrate the benefits of partnering with BAYADA Hospice. For example:

For BAYADA Sales Training Only Confidenal| 47 o “Studies show that integrating hospice care into nursing homes significantly reduces hospitalizations and enhances symptom management, ensuring residents receive compassionate, tailored care. By partnering with BAYADA Hospice, you’ll improve overall satisfaction for both residents and their families.” 5. Commit (Provide an If-Then Statement to Gain a Yes for a Referral or Another Meeting) • Use If-Then Statements: Encourage commitment by using conditional statements that lead to a clear next step. For example: o “If we can show you how BAYADA Hospice can reduce your hospitalization rates by 40%, would you be willing to schedule a follow-up meeting to discuss implementation?” o “If we can provide training and support that improves your staff’s ability to manage end-of-life care, would you consider referring your next eligible patient to BAYADA Hospice?” 6. Evaluate and Deepen (Follow Up with Data, Success Stories, and a Commitment to Continue to Drive Value Deeper in the Account) • Follow Up Regularly: After the initial meeting, follow up with additional data, success stories, and any requested information. Ensure that you maintain regular communication to build trust and rapport. • Provide Ongoing Support: Offer continuous support and resources to the LTC facility. Share updates on patient outcomes, new services, and training opportunities. • Deepen the Relationship: Look for opportunities to deepen the partnership by addressing additional needs and providing value-added services. For example, offer to conduct in-service training sessions or provide educational materials for staff and families.

For BAYADA Sales Training Only Confidenal| 48 Additional Resources Account Profiling Handling Objections Introduction to Care Planning for Long-Term Residents with Chronic Diseases

For BAYADA Sales Training Only Confidenal| 49 Account Profiling in the Long-Term Care Facility When building a referring relationship with a long-term care (LTC) facility, a business development specialist should gather the following important pieces of information: 1. Facility Profile • Number of Licensed Beds: Total number of beds and how many are Medicare certified. • Resident Demographics: Number of residents in long-term care versus skilled nursing. • Current Hospice Providers: Which hospice agencies are currently providing services. 2. Key Decision Makers • Roles and Responsibilities: Identify the key decision makers such as the Administrator, Director of Nursing, Social Service Designees, MDS Coordinator, and Admissions Team. • Influence and Decision-Making Power: Understand who has the authority to decide on hospice partnerships and what factors influence their decisions. 3. Care Coordination and Processes • Referral Process: How the facility identifies and refers residents to hospice care. • Care Plan Meetings: Schedule and frequency of care plan and Medicare meetings. • Discharge Planning: How the facility manages transitions from skilled care to hospice. 4. Facility Needs and Challenges • Primary Concerns: Key challenges the facility faces in providing end-of-life care. • Pain Points: Specific issues related to patient care, staff training, and regulatory compliance. • Expectations from Hospice Providers: What the facility expects in terms of support, communication, and care quality. 5. Financial and Operational Impact • Revenue Considerations: Impact of hospitalizations on revenue and potential cost savings from reduced hospitalizations. • Reimbursement Rates: Understanding of Medicare and Medicaid reimbursement rates and how hospice care can affect these. • Contractual Agreements: Existing contracts with hospice providers and any respite care agreements.

For BAYADA Sales Training Only Confidenal| 50 6. Quality Measures and Compliance • CMS Quality Measures: How the facility performs on CMS quality measures and how hospice care can help improve these metrics. • Regulatory Compliance: Requirements for compliance with state and federal regulations. 7. Patient and Family Needs • Common Diagnoses: Most challenging diagnoses to treat and why. • Family Concerns: Common concerns families have about hospice care. • Patient Outcomes: Desired outcomes for patients receiving hospice care. 8. Staff Training and Support • Training Needs: Key training needs for nursing staff and certified nursing assistants. • Support from Hospice: Types of support the facility expects from hospice providers, such as in-service training and educational materials. 9. Feedback and Success Stories • Past Experiences: Feedback from previous interactions with hospice providers. • Success Stories: Examples of successful hospice partnerships and positive outcomes.

For BAYADA Sales Training Only Confidenal| 51 Possible Objections When selling hospice services to different roles in a long-term care (LTC) facility, a business development specialist may encounter various objections. Here are some common objections and strategies to address them: Administrator Objections: 1. Cost Concerns: “How will this affect our budget?” 2. Revenue Impact: “Will this reduce our revenue from Medicare/Medicaid?” 3. Regulatory Compliance: “How does this align with our compliance requirements?” Strategies: • Cost Savings: Highlight how hospice care can reduce hospitalizations and associated costs, leading to overall savings. • Revenue Enhancement: Explain how improved patient outcomes and compliance with CMS quality measures can positively impact reimbursement rates. • Compliance Support: Provide information on how hospice services help meet regulatory requirements and improve quality measures. Director of Nursing (DON) Objections: 1. Quality of Care: “Will hospice care meet our standards for patient care?” 2. Staff Integration: “How will hospice staff integrate with our nursing team?” 3. Survey Preparation: “Will this complicate our survey preparations?” Strategies: • Quality Assurance: Share data and case studies demonstrating improved patient outcomes with hospice care. • Collaborative Approach: Emphasize the collaborative nature of hospice care and the support provided to nursing staff. • Survey Readiness: Explain how hospice services can enhance care quality and help meet survey requirements. Nursing Supervisors Objections: 1. Patient Care: “Will hospice care disrupt our current patient care routines?”

For BAYADA Sales Training Only Confidenal| 52 2. Communication: “How will we ensure effective communication between hospice and our staff?” 3. Family Concerns: “How will families react to hospice care?” Strategies: • Seamless Integration: Highlight how hospice care can be integrated smoothly into existing care routines. • Clear Communication: Provide examples of effective communication strategies and regular interdisciplinary meetings. • Family Education: Offer educational materials and support to help families understand and accept hospice care. Social Service Designees / Directors of Social Service Objections: 1. Referral Process: “Is the referral process complicated?” 2. Family Resistance: “Families often resist hospice care. How can we address this?” 3. Support Services: “What additional support does hospice provide?” Strategies: • Simplified Referrals: Explain the straightforward referral process and provide step-by-step guides. • Family Engagement: Share success stories and testimonials from families who have benefited from hospice care. • Comprehensive Support: Detail the emotional, spiritual, and practical support services offered by hospice. Director of Staff Development (DSD) Objections: 1. Training Needs: “Will our staff need additional training?” 2. Staff Burden: “Will hospice care add to our staff’s workload?” 3. In-Service Scheduling: “How will we fit hospice training into our schedule?” Strategies: • Training Programs: Offer comprehensive training programs tailored to the facility’s needs. • Supportive Role: Explain how hospice care can alleviate some of the burdens on nursing staff by providing specialized end-of-life care.

For BAYADA Sales Training Only Confidenal| 53 • Flexible Scheduling: Provide flexible training options to fit into the facility’s existing schedule. MDS Coordinator Objections: 1. Documentation: “Will hospice care complicate our documentation process?” 2. Medicare Compliance: “How does hospice care affect our Medicare compliance?” 3. Patient Eligibility: “How do we determine which patients are eligible for hospice?” Strategies: • Streamlined Documentation: Explain how hospice care supports accurate and streamlined documentation. • Compliance Assurance: Provide information on how hospice services align with Medicare requirements. • Eligibility Criteria: Offer clear guidelines and support for identifying eligible patients. Admissions Team Objections: 1. Family Concerns: “How do we address families’ concerns about hospice care?” 2. Referral Advocacy: “How do we advocate for hospice during admissions?” 3. Marketing Support: “What marketing support does hospice provide?” Strategies: • Family Education: Provide educational materials and support to address families’ concerns. • Referral Support: Offer training and resources to help the admissions team advocate for hospice services. • Marketing Materials: Supply brochures, case studies, and testimonials to support marketing efforts. Business Office Manager Objections: 1. Financial Impact: “How will hospice care affect our financials?” 2. Contract Management: “What are the terms of the hospice contract?” 3. Reimbursement Rates: “How does hospice care impact our reimbursement rates?”

For BAYADA Sales Training Only Confidenal| 54 Strategies: • Financial Benefits: Highlight the cost savings and financial benefits of reduced hospitalizations and improved care quality. • Clear Contracts: Provide clear and favorable contract terms. • Reimbursement Support: Explain how hospice care can positively impact reimbursement rates through improved patient outcomes and compliance. By understanding and addressing these common objections, a business development specialist can effectively communicate the value of hospice services and build strong referral relationships with LTC facilities. Simple Objection Turn Around Strategy An effective objection turnaround process can help a business development specialist address concerns and objections from long-term care (LTC) facility decision makers efficiently and confidently. Here’s a step-by-step process that can be helpful: 1. Listen Actively • Fully Understand the Objection: Pay close attention to the objection without interrupting. Ensure you understand the concern fully before responding. • Acknowledge the Concern: Show empathy and validate the concern. For example, “I understand that you’re worried about the impact on your budget.” 2. Clarify and Probe • Ask Clarifying Questions: Ensure you have all the details about the objection. For example, “Can you tell me more about your concerns regarding the cost?” • Probe for Underlying Issues: Sometimes the stated objection is a surface-level concern. Ask questions to uncover any deeper issues. For example, “Is there a specific experience that has led to this concern?” 3. Address the Objection • Provide Relevant Information: Use data, case studies, and examples to address the concern. For example, “Studies show that integrating hospice care can reduce hospitalizations by up to 47%, leading to significant cost savings.” • Tailor Your Response: Customize your response to the specific needs and concerns of the decision maker. For example, “For your facility, this could mean saving approximately $18,000 annually.”

For BAYADA Sales Training Only Confidenal| 55 4. Reframe the Conversation • Highlight Benefits: Shift the focus to the positive outcomes and benefits of hospice care. For example, “By partnering with BAYADA Hospice, you’ll not only save costs but also improve patient outcomes and family satisfaction.” • Use If-Then Statements: Encourage commitment by using conditional statements. For example, “If we can demonstrate these savings and improvements, would you be open to scheduling a follow-up meeting?” 5. Confirm Understanding • Check for Agreement: Ensure the decision maker understands and agrees with your response. For example, “Does this address your concern about the budget impact?” • Seek Feedback: Ask if there are any other concerns or questions. For example, “Is there anything else you’re worried about that we haven’t covered?” 6. Follow Up • Provide Additional Information: Send follow-up materials such as detailed reports, case studies, or testimonials that reinforce your points. • Maintain Communication: Keep the lines of communication open to address any further concerns and build trust. For example, “I’ll follow up with a detailed report on cost savings and patient outcomes. Let’s schedule a call next week to discuss any further questions.” Example Scenario Objection: “I’m concerned about the time loss associated with changing hospice providers and adapting to a new process.” Turnaround Process: 1. Listen Actively: o “I understand that you’re worried about the time loss involved in switching hospice providers and adapting to a new process.” 2. Clarify and Probe: o “Can you tell me more about your specific concerns regarding the transition and the new process?”

For BAYADA Sales Training Only Confidenal| 56 3. Address the Objection: o “I appreciate your concern. Transitioning to a new hospice provider can seem daunting, but our team at BAYADA Hospice is experienced in making this process as seamless as possible. We have a dedicated transition team that works closely with your staff to ensure minimal disruption and a smooth integration.” 4. Reframe the Conversation: o “By partnering with BAYADA Hospice, you’ll benefit from our streamlined processes and comprehensive support, which can actually save time in the long run. Our goal is to enhance patient care and improve efficiency. If we can demonstrate how our transition plan minimizes time loss and improves outcomes, would you be open to scheduling a follow-up meeting?” 5. Confirm Understanding: o “Does this address your concern about the time impact of changing providers?” 6. Follow Up: o “I’ll follow up with a detailed transition plan and examples of how we’ve successfully integrated with other facilities. Let’s schedule a call next week to discuss any further questions.” o Example Scenario Objection: “Our facility already provides comfort care. Why do we need a hospice team to provide end-of-life services?” Turnaround Process: 1. Listen Actively: “I understand that your facility is dedicated to providing comfort care for your residents.” 2. Clarify and Probe: “Can you tell me more about the specific comfort care services you currently offer and any challenges you face in providing comprehensive end-of-life care?” 3. Address the Objection: “While your facility provides excellent comfort care, hospice teams offer a full suite of specialized end-of-life services that go beyond basic comfort measures. These services include advanced pain and symptom management, emotional and spiritual support, and 24/7 on-call availability, all of which are required by the hospice Conditions of Participation.” 4. Reframe the Conversation: “By partnering with BAYADA Hospice, your residents will benefit from a multidisciplinary team approach that includes physicians, nurses, social

For BAYADA Sales Training Only Confidenal| 57 workers, and chaplains, ensuring comprehensive care that addresses all aspects of their needs. This collaboration can enhance the quality of life for your residents and provide additional support to your staff.” 5. Confirm Understanding: “Does this help clarify the additional benefits that a hospice team can bring to your facility’s end-of-life care?” 6. Follow Up: “I’ll follow up with detailed information on the specific services provided by our hospice team and how they align with the hospice Conditions of Participation. Let’s schedule a call next week to discuss any further questions and explore how we can work together to enhance your residents’ care.”

For BAYADA Sales Training Only Confidenal| 58 Introduction to Care Planning for Long-Term Residents with Chronic Diseases Care planning is a vital process in long-term care facilities, ensuring that residents receive personalized and comprehensive care tailored to their unique needs. For residents with chronic diseases, effective care planning becomes even more crucial, as it helps manage their conditions and enhances their quality of life. This introduction will explore the roles and responsibilities involved in care planning, the timing and frequency of care planning sessions, and the assessment tools used to identify residents who may benefit from hospice services. In long-term care settings, an interdisciplinary team (IDT) collaborates to develop and implement care plans. This team typically includes primary nurses, physicians, social workers, dietitians, physical and occupational therapists, and, when necessary, hospice nurses. A key member of this team is the MDS Coordinator, who ensures accurate and comprehensive documentation of resident assessments and care plans, coordinating the Minimum Data Set (MDS) assessments. Family members also play a crucial role, providing valuable insights and support during care planning meetings. Care planning begins with an initial assessment upon admission, followed by regular reviews and updates to ensure the care plan remains relevant and effective. For residents with chronic diseases, specific assessment tools such as the Comprehensive Geriatric Assessment (CGA), Palliative Performance Scale (PPS), Karnofsky Performance Status Scale (KPS), Edmonton Symptom Assessment System (ESAS), FAST Scale, NYHA Classification, and the Flacker Mortality Index are used to monitor their health status and determine hospice eligibility. By understanding the importance of timely and accurate care planning, long-term care staff can better support residents with chronic diseases, ensuring they receive the appropriate care and comfort they need. This approach not only improves the residents’ quality of life but also provides peace of mind for their families This next section is designed to educate long-term care facility staff on the process of care planning for residents, with a special focus on those with chronic diseases who may need hospice services. The training covers who is involved in care planning, the timing and frequency of care planning, and the relevant assessment tools used. Objectives • Understand the roles and responsibilities in care planning. • Learn the timing and frequency of care planning sessions. • Familiarize with assessment tools for chronic disease management and hospice eligibility. • Enhance skills in identifying residents who may benefit from hospice services.

For BAYADA Sales Training Only Confidenal| 59 1. Roles and Responsibilities in Care Planning Interdisciplinary Team (IDT): • Primary Nurse: Coordinates daily care, monitors health status, and communicates changes to the team. • Physician: Provides medical oversight, diagnoses, and treatment plans. • Social Worker: Supports emotional and social needs, assists with advance care planning. • Dietitian: Manages nutritional needs and dietary plans. • Physical/Occupational Therapist: Develops rehabilitation plans and assists with mobility issues. • Hospice Nurse (if applicable): Provides specialized care for residents eligible for hospice services. • Family Members: Participate in care planning meetings to provide input and support. 2. Timing and Frequency of Care Planning Initial Care Plan: • Developed within 48 hours of admission. • Comprehensive care plan completed within 7 days of admission. Ongoing Care Planning: • Reviewed and updated at least every 90 days. • Additional reviews triggered by significant changes in the resident’s condition. Hospice Care Planning: • Initiated when a resident is identified as hospice-eligible. • Hospice care plan integrated with the existing care plan and reviewed regularly. 3. Assessment Tools Comprehensive Geriatric Assessment (CGA): • Evaluates medical, psychological, and functional capabilities. • Identifies needs and formulates a coordinated care plan. Palliative Performance Scale (PPS): • Assesses functional status and helps determine hospice eligibility. • Scores range from 0% (death) to 100% (full health). Karnofsky Performance Status Scale (KPS):

For BAYADA Sales Training Only Confidenal| 60 • Measures the ability to perform daily activities. • Scores range from 0 (dead) to 100 (normal, no complaints). Edmonton Symptom Assessment System (ESAS): • Monitors symptoms such as pain, fatigue, and shortness of breath. • Helps in managing symptoms and improving quality of life. FAST Scale (Functional Assessment Staging Test): • Specifically for residents with Alzheimer’s disease. • Stages range from 1 (normal adult) to 7 (severe Alzheimer’s). NYHA Classification (New York Heart Association): • Classifies the extent of heart failure. • Ranges from Class I (no symptoms) to Class IV (severe symptoms). Flacker Mortality Index: • Predicts 1-year mortality risk for newly admitted nursing home residents. • Factors include age, gender, BMI, presence of chronic diseases, and functional abilities1. 4. Identifying Hospice-Eligible Residents General Criteria used for Hospice Eligibility: • Life expectancy of 6 months or less if the disease runs its normal course. • Significant decline in clinical status. • Frequent hospitalizations or emergency room visits. • Progressive weight loss and decreased appetite. • Increased dependence on activities of daily living (ADLs). Steps to Identify Hospice-Eligible Residents: 1. Regular Monitoring: Use assessment tools to track changes in health status. 2. Interdisciplinary Meetings: Discuss potential hospice eligibility during care planning meetings. 3. Family Discussions: Communicate with family members about the benefits of hospice care. 4. Referral to Hospice: Coordinate with hospice providers to initiate services.

For BAYADA Sales Training Only Confidenal| 61 Conclusion Effective care planning for long-term residents, especially those with chronic diseases, requires a coordinated effort from the interdisciplinary team. By using appropriate assessment tools and regularly reviewing care plans, staff can ensure that residents receive the best possible care and timely hospice referrals when needed. This training aims to equip staff with the knowledge and skills to enhance the quality of life for their residents 1: Flacker Mortality Index The Importance of Understanding Assessment Rhythms for Business Development For a business development (BD) specialist in the hospice industry, understanding the rhythm of assessments within long-term care facilities is crucial for building successful collaborations and fostering timely hospice referrals. The assessment schedule and care planning processes provide valuable insights into when and how to engage with the care team effectively. By aligning with the facility’s assessment rhythm, a BD specialist can identify optimal times to introduce hospice services, participate in care planning meetings, and offer support during critical decision-making moments. This strategic approach not only enhances the specialist’s ability to build strong relationships with key stakeholders but also ensures that residents receive the appropriate care at the right time. Here are some strategic moments to consider: 1. Initial Admission and Assessment:o When a new resident is admitted to a long-term care facility, the initialassessment provides a comprehensive overview of their health status. This is anopportune time for the business development specialist to introduce hospiceservices and discuss potential benefits with the care team.2. Care Plan Review Meetings:o Regular care plan review meetings, typically held every 90 days or when thereare significant changes in a resident’s condition, are ideal for discussing hospiceeligibility. The specialist can attend these meetings to provide insights on hospicecare and identify residents who may benefit from early referrals.3. Significant Health Declines:o When a resident experiences a significant decline in health, frequenthospitalizations, or worsening symptoms, it is crucial to reassess their careneeds. The business development specialist can collaborate with the care teamto evaluate hospice eligibility and discuss how hospice services can improve theresident’s quality of life.

For BAYADA Sales Training Only Confidenal| 62 4. Family Meetings:o Engaging with families during care planning meetings or separate familymeetings is essential. The specialist can provide education on hospice care,address any concerns, and highlight the benefits of early hospice referrals,ensuring families are well-informed and comfortable with the decision.5. Educational Sessions and Training:o Offering educational sessions and training for long-term care staff on hospiceeligibility criteria and the benefits of early hospice referrals can fostercollaboration. The business development specialist can lead these sessions,building strong relationships with the care team and ensuring they are equippedto identify hospice-eligible residents.Discovery Questions for Timing and Key Contacts For Timing: 1. “Can you tell me about your care planning schedule? When are the regular reviewmeetings held?”o This helps identify the routine times when the care team meets to discussresident care plans, providing an opportunity to join these meetings.2. “What are the typical triggers for reassessing a resident’s care plan?”o Understanding the triggers for reassessment (e.g., significant health declines)can help the BD specialist know when to follow up.3. “Are there specific times of the year or month when you review hospice eligibilityfor residents?”o This question helps pinpoint any cyclical or scheduled reviews that the BDspecialist can align with.For Key Contacts: 1. “Who are the primary decision-makers involved in the care planning process?”o Identifying the key individuals, such as the primary nurse, physician, MDS coordinator, and social worker, ensures the BD specialist knows whom to approach.

For BAYADA Sales Training Only Confidenal| 63 2. “Can you share who typically attends the family meetings and care plan reviews?”o This helps the BD specialist understand the composition of the team and family members involved, allowing for more targeted communication.3. “Who would be the best person to discuss potential hospice referrals with?”o Directly asking for the appropriate contact person ensures that the BD specialist engages with the right individual who can facilitate hospice referrals.