Following a Patient on Hospice

Once a patient is admitted to Hospice, his or her relationship with the primary provider remains the same. The patient can continue to make office visits, which continue to be covered as they have been by the patient’s primary insurance. Many providers fear that an admission to Hospice means that their hands will be tied in terms of testing and treatment. As the patient has expressed a desire to seek palliative versus curative care, determining whether treatments and testing will fall within a patient’s plan of care is done by looking at the goal of the intervention. If a treatment is primarily palliative in nature or if a test is needed for symptom control, they will fall within the plan of care. Hospice then will coordinate and cover that treatment or testing.

If a patient’s symptoms cannot be adequately controlled in a home setting, Hospice will arrange for and cover a short term in-patient stay at a local hospital to provide that symptom control. Hospice also offers short term – up to 5 days – in-patient respite stays at local hospitals to provide caregiver respite. The primary provider will be asked to cover the patient in the hospital during these times.

Each patient’s case is fully reviewed by our whole team every two weeks. We are required by Medicare to review each admitted patient every 90 days for the first 6 months and every 30 days after the first 6 months to determine whether the patient still meets the eligibility requirements for Hospice. While this is an internal process, we may be turning to the practitioners at this time for their clinical opinion. If a patient does not continue to meet Hospice eligibility requirements (has a prognosis of over 6 months) they will be graduated from the program with full discharge planning. If they require our services again in the future, we are able to step right back in. There is no limit to how long someone can be admitted to Hospice as long as they continue to meet our eligibility requirements.

At the time of death, the primary physician will be asked to sign the death certificate. As the death is considered to be an expected death, the physician does not need to attend. There is also no need for coroner involvement. The Hospice team will coordinate with the funeral home to assure that the patient’s final wishes are fulfilled.