Center to Advance Palliative Care

From your question, it appears that the patient elected hospice while hospitalized. I will address the billing for that consideration and then ask for clarification about your question.

If the patient elects hospice while in the hospital, that patient is 'discharged' from the hospital and 'admitted to hospice' as a paper transfer. This action requires that the hospice and the hospital have a signed contract allowing the hospice patients to receive inpatient hospice services. Most hospice patients are Medicare patients so the explanation above relates primarily to that patient population. Medicaid inpatient hospice coverage and financial considerations are somewhat more complicated as State provisions apply. Private insurers have their own rules and requirements.

Under the circumstances outlined in your question and assuming that the patient is a Medicare patient, the hospice bills Medicare for General Inpatient Care and reimburses the hospital as per the contractual agreement. CAPC has a new tool describing the responsibilities of both the hospital and the hospice under this arrangement: Guide for Drafting a Contract between a Hospital and a Hospice for Inpatient Hospice Services. Go to: http://www.capc.org/tools-for-palliative-care-programs/tools-for-hospice-hospital-relationships/

Could you please clarify what you mean when you say 'this is not a 'swing bed' status? Is your concern about the appropriateness of the clinical condition for an inpatient hospice stay or about or the availability of a specific bed designated as a 'swing bed'?