Today's Hospice. It's not what you think - page 2

by katie'sangel 9,310 Views | 19 Comments

As patient advocates, we need to understand the appropriate use of hosppice. Families and patients are suffering needlessly without it. Recent research by the National Hospice and Palliative Care Organization shows over 1/2 the... Read More


  1. 5
    Quote from mclennan
    Great article. My only issue is that the Medicare guidelines sometimes create "hospice hoppers," because the term is only 6 months. It's sometimes the case that because the palliative care provided during the term prevented decline so well, the patient is discharged as soon as 6 months is up. Then they have to appeal or find another hospice. It's kind of weird.

    Not true, totally untrue, and a reason that people make the wrong decision. You can be on the Medicare hospice benefit as long as you meet criteria (and cases are audited q3months). You can "flunk" hospice-- Art Buchwald famously did this, he got better, and went off service for several months after good care made him feel better. Then you can come back, as he did, without wait period or penalty, if you meet criteria again. I had a hospice patient who was on service for two years, and he met criteria all along.

    NO hospice will accept you if you do not meet criteria-- this is a very regulated industry. There's no point to "hospice-hopping."
    Spidey's mom, tewdles, ktliz, and 2 others like this.
  2. 0
    huh
    need more patience
  3. 1
    I'm a huge fan of hospice though the quality of the care can be highly variable even within the same hospice agency.

    A good hospice nurse might be one of the most important healthcare clinicians that some people ever have.

    Dying can be handled so much better than it often is.... 'tis terribly sad to be to see EOL happening in the hospital.
    GrnTea likes this.
  4. 0
    You as a RN have to be very cautious about what you say to patients regarding hospice care. Remember Amanda Trujillio?
  5. 0
    I've worked in hospice and it's quite an experience have learned a lot!
  6. 0
    Quote from hope3456
    You as a RN have to be very cautious about what you say to patients regarding hospice care. Remember Amanda Trujillio?
    I remember, anyone have an update on her and her case??
  7. 0
    Quote from hope3456
    You as a RN have to be very cautious about what you say to patients regarding hospice care. Remember Amanda Trujillio?
    I've read a little more in depth about her...it's just not that she suggested hospice, it's that she went away above the scope of practice.
  8. 0
    Quote from katie'sangel
    New regulations by Medicare require more frequent visit by the hospice doctor or a nurse practitioner. MD or NP has to see pt about once a month, depending on how long the pt has been on hospice
    Actually, per medicare guidelines, MD or NP have to see the pt after 180 days and then every 60 days. Multiple admissions to service change the time of the first visit from the MD/NP.
  9. 0
    Quote from chrisrn24
    I've read a little more in depth about her...it's just not that she suggested hospice, it's that she went away above the scope of practice.
    Here is a link to the boards order: https://www.azbn.gov/ConsentAgreements/1104073.pdf


    Last edit by hospicern030363 on Jul 2, '13
  10. 0
    "According to the Center for Medicare and Medicaid Services, over Ĺ of the hospice organizations in the United States in 2010 were operated by for-profit companies. Driven by profit instead of ethics, not all hospice agencies give the same quality of care."

    Great article. Thank you. The only thing I disagree with is the implication that all for-profit facilities don't care about ethics and only care about money, profit. While that can be the case sometimes, that can also be the case with non-profits, as well. Really, there can be fundamentally no difference between a for-profit and non-profit as far as ethics/money go. I have seen a non-profit or two that do not really qualify as non-profits.

    Point being: both non-profits and for-profit organizations can either be wonderful, caring organizations or they can be the opposite of wonderful. That has more to do with the administration itself than the actual infrastructure of the organization (non profit vs for profit).

    In the future, I thought I might want to start a hospice house (though I realize it's highly unlikely), and I was thinking non-profit would be the way to go mainly because of this gross misconception in the public that "all nonprofits are awesome, and for-profit organizations are money mongers." Not true at all.


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