Discharge from hospice

[curiousinCA]

Hello. I was hoping someone would be able to offer a somewhat detailed account of the process of decertification and being discharged from hospice. What's the criteria or how is it established by physician or nurse that what was a terminal diagnosis is now deemed an improvement enough that the patient is no longer in need of hospice care? And what's the process of discharging the patient; does he or she just get up and go back home? Thanks in advance everyone.

[Kabin]

It all depends on the reason for discharge. In general, the hospice team assesses and charts a pt's appropriateness for hospice. Different scales like PPS, MMSE, and FAST are used to measure decline. The pt's weight, intake and ability to swallow may also come into play. There's lots of Medicare fraud today and hospice is no exception.

Most patients are already in the home. Here's some details:

Discharge from Hospice Services | National Hospice and Palliative Care Organization

[TammyG]

Patient's don't need to improve in order to be discharged from hospice -- they just need to not decline. (Lots of double negatives in there.) It is a medical decision and the responsibility of the MD, but it is not at all unusual in a large hospice to discharge several non-cancer patients each year. A safe discharge must be planned. These patients are all at home or in LTD facilities and just stay there. It is often difficult for the family because they have come to rely on the support from hospice.