Eligibility & Medical Guidelines

The primary focus of Hospice care is on pain and symptom management along with other supportive measures.  Hospice is an alternative to aggressive medical regimes which may no longer be helpful or desired. For a procedure or treatment to be considered appropriate as part of the Hospice care plan, the patient, primary caregiver, physician and Hospice interdisciplinary team must review the treatment in light of the patient’s life expectancy and quality of life at that point in time. Treatment decision-making is thus focused on enhancing the quality of the patient’s remaining life.

According to Hospice regulations, and in order to be covered by insurance, all services and medical treatments must be reasonable and necessary for the management of the life-limiting condition and pre-authorized by Hospice. Hospice care includes optimizing the patients’ ability to participate in activities of daily living.  Hospice provides teaching for patients and caregivers regarding the provision of safe care which promotes patient’s comfort.

Medications will be ordered for the control of pain and other symptoms in order to achieve maximum comfort. Diagnostic tests and other assessments are appropriate when results are needed to obtain additional information in an attempt to try to improve pain and/or symptom management. Testing for the purpose of evaluating progression of disease is usually no longer appropriate unless for the purpose of symptom and pain management.

A Do Not Resuscitate Order (DNR) is appropriate for hospice patients but is not required. Hospice team members are not obligated to perform heroic measures such as cardiopulmonary resuscitation (CPR) on a Hospice patient for whom a DNR order is not in effect. The hospital medical staff will assume this responsibility when the patient is in the hospital. For hospice patients at home or in a long-term care facility, families are encouraged and/or assisted in calling existing emergency medical services such as 911.

Hospice provides an on-call service that is available to patients and families 24 hours a day, 7 days a week, to handle questions, problems, and emergencies, and to provide home visits as needed. Ambulance or emergency room services are not covered unless authorized by the Hospice plan of care.

Patients are always free to withdraw (revoke) from Hospice at any time and for any reason. If a patient decides to pursue curative or more aggressive therapy through medical intervention, the patient’s choice to withdraw from Hospice will be respected.