Revoking Hospice

I work in an office in a hospice, we have patients revoke and come back all the time. I think one person came on and revoked 5 or 6 times. It seems to raise the question whether or not the patient is really getting the concept of hospice. I have heard that revoking so often really raises red flags with medicare, but I guess as long as the doc will still sign a certification of terminal illness each time, these patients will keep using us as a revolving door.

I work in an office in a hospice, we have patients revoke and come back all the time. I think one person came on and revoked 5 or 6 times. It seems to raise the question whether or not the patient is really getting the concept of hospice. I have heard that revoking so often really raises red flags with medicare, but I guess as long as the doc will still sign a certification of terminal illness each time, these patients will keep using us as a revolving door.

I agree with you about some patients not getting the hospice concept. Or maybe they get it, but just use the system as it exists to met their needs. Anyway, years ago there was a limited number of hospice benefits, and if a patient revoked or was discharged in the last available benefit period, they had no more benefit to access. They could still technically get hospice care, just not have insurance reimbursement for it. These days the benefit periods are unlimited, so it's not a problem. At least not a reimbursement problem.

Gail

There are other reasons for revoking hospice, as well. For example, the hospice I work for doesn't have a contract for in-patient care with the VA hospital, and a few others. If a patient goes into one of those facilities, they revoke their Medicare hospice benefit, then are readmitted when they are released.