Hospice Eligibility

An individual with a life-limiting illness is eligible for hospice care when two physicians agree the person has a life expectancy of 6 months or less if the illness were to take it’s natural course. The person must decide to pursue comfort only treatment. If an individual decides to pursue curative treatment, they will not be eligible for hospice care. When choosing hospice, the patient will sign consent forms to elect the hospice benefit. If the patient lives for longer than 6 months, they are still eligible for hospice care if they meet guidelines that they continue to be terminally ill. The hospice medical director will recertify the patient if they are still eligible for care. Hospice is made up of benefit periods. For the first 6 months, the patient will have two 90-day benefit periods. After the two 90-day benefit periods, the patient will have an unlimited number of 60-day benefit periods. A hospice medical director reviews the patient at each benefit period for recertification.

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Change of the Hospice Benefit

 

Discharges
A patient may be discharged from hospice for a number of reasons:

• The patient is found to no longer be terminally ill

• Unsafe situation for the hospice team

• Lack of attending physician

• Lack of caregivers in the home, creating an unsafe environment

• Patient / healthcare proxy / decide to discontinue hospice

Revocation
A patient may choose to revoke their hospice benefit at any time. If at any point it is decided the patient is going to undergo curative treatments, they can revoke the hospice benefit in order to do so.

Transfers

The patient may transfer to a different hospice when moving out of Tides Hospice service area. Transfers are allowed once per benefit period.

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