Reasons for Discharge
While most hospice patients remain in hospice care until they die, discharge may be initiated either by the patient and family or by the hospice program, for reasons that include:
- The patient or family is not satisfied with the hospice program and wants to choose another provider.
- The patient moves to a residence outside the hospice program's service area.
- The patient improves and no longer needs hospice care; in this case, the doctor will not continue to certify periods of care. In some cases where there is significant improvement in the patient's condition, the hospice may discharge the patient even before the current period of care has ended.
- The patient desires curative treatment, which is not provided in hospice.
- The patient or family fails to comply with the plan of care.
- There are serious issues of safety, for the patient or staff, which cannot be resolved.
If the hospice program does not provide in-patient hospice services, it must have a written transfer agreement with a hospice program that provides those services, and they must assist with arranging the transfer when necessary.
The hospice social worker or another member of the hospice team will assist you in completing discharge paperwork and in finding other suitable resources. You will receive a copy of the discharge summary, outlining the recommendations for the patient's care. If the patient is discharged, the patient or responsible party should notify the health insurance company, unless the hospice program has already done so.
Appealing an Involuntary Discharge
When hospice programs initiate discharge, it is usually because the patient has improved and is no longer eligible for hospice care. When the patient is no longer eligible due to improvement in his or her condition, the insurance company will no longer pay for hospice care. Patients have rights to appeal denials from Medicare, Medical Assistance, the Department of Veterans Affairs, and private insurance companies. Contact the insurance company for information about the appeals process.
Re-enrolling in a Hospice Program
If the patient's condition changes and he or she is discharged from hospice care, re-enrollment is possible when the patient again becomes medically eligible for care. A patient who has chosen to leave a hospice program may re-enroll in hospice care if medically eligible for service.