Discharge From Hospice
The majority of discharges from hospice are due to the death of the patient, although hospice treatment may not end then as care also provides for a period of bereavement counseling for the family afterward. However, there are several other scenarios when a patient may be discharged from hospice.
- De-certification
- If it is determined at the time of review that a patient's prognosis may be greater than six months, the patient is de-certified (discharged) from hospice. The hospice is required by law to give advance notification to the patient, and the patient can appeal the hospice's decision to Medicare. Usually the hospice plans these discharges weeks in advance to make the transition off hospice, which can be traumatic for patients who have been preparing to die, as smooth as possible. Should the patient's condition worsen once discharged from hospice they can be readmitted to hospice.
- Revocation
- A patient may be discharged by revocation if he or she chooses to relinquish the hospice benefit. Revocation could be due to hospitalization, if the patient chooses to pursue some type of curative treatment or experiences dissatisfaction with hospice care. However, not all hospitalizations of patients require revocation; should the admitting diagnosis to the hospital be unrelated to the condition for which they are in hospice, the patient may remain on hospice while undergoing treatment for it.
- Transfer of hospice
- Transfer of hospice does not involve a discharge from hospice in general, but a discharge from the current hospice provider to another one.
- Discharge for cause
- Occasionally a hospice will be unable to provide care to a patient, either due to philosophical differences with the patient or due to a safety issue. Such causes could include disruptive or abusive behavior from the patient or other persons in the patient's home or refusal to cooperate with the hospice program. Patients may, after being discharged from hospice for any reason, re-enroll in hospice at a later date as necessary.
Read more about this topic: Hospice Care In The United States
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