Discharged from Hospice: Now What?
According to Centers for Medicare & Medicaid Services (CMS) requirements, a hospice patient must be terminally ill with a life expectancy of six months or less if their illness runs its normal course. The goal of hospice care is to provide these terminally ill patients with pain and symptom management allowing them to maintain the highest possible quality of life for the remainder of their lives. Hospice care does not extend life nor does it hasten death.
But with the increased care of their hospice team providers, sometimes patients improve. In fact, studies show that cancer patients receiving hospice care live, on average, 29 days longer than patients who do not receive the support of hospice.
And sometimes patients are doing so well that they can no longer be certified as terminally ill under Medicare requirements. In these cases, the patient must be discharged.
What happens when a patient is discharged from hospice?
A patient may receive a hospice discharge for a number of a reasons. These include:
- The patient is determined to have an extended prognosis of more than six months to live
- The patient decides to stop hospice services
- The patient moves out of the hospice service area
- The patient is discharged for cause. In these cases, the hospice determines the patient or others involved in their care are compromising the ability of the hospice to effectively provide care with disruptive, abusive, or uncooperative behavior
The hospice will make every effort to resolve issues before it considers a hospice discharge.
However, if it is determined that a hospice discharge is needed, the hospice medical director will write a physician discharge order. If the patient has another doctor following their care, they will be consulted before the discharge occurs.
Crossroads Hospice & Palliative Care works with caregivers in advance of a possible discharge to ensure they will have all the support, medical equipment, supplies, and prescriptions they need for a smooth transition.
One option for patients with an extended prognosis is transitioning to Crossroads’ palliative care program. On the palliative care program, the palliative care coordinator will work the patient, their family, and their physicians to continue to follow the patient and provide additional support in the home. The palliative care team consists of a nurse practitioner and a social worker who visit the patient in their place of residence to provide care and connect them with additional resources.
Appealing a Hospice Discharge
Patients have the right to appeal a hospice discharge if they believe services are ending too soon. Crossroads provides all patients with information on this process at the time of the hospice discharge.
Once a patient or their family begins an appeal of a hospice discharge, a CMS contractor will review the patient’s medical records and determine whether the patient should be discharged or if they may continue to receive hospice care.
If the patient is deemed eligible to receive services, Crossroads will work quickly to resume hospice services to the patient.
Returning to Hospice Care
Patients who have been discharged due to an extended prognosis or because they chose to revoke services are able to return to Crossroads for hospice care if their condition worsens and they once again meet the eligibility requirements for hospice care.
Crossroads is available 24 hours a day, 7 days a week, 365 days a year to admit patients. For questions about hospice or palliative care, please contact us at 1-888-564-3405.
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