Center to Advance Palliative Care

You will want to be cautious providing care for patients that the hospice has not been ordered or consulted on to provide care. Medicare has guidelines that hospice is not to "give away care." If your position is partially funded by hospice and the hospital that needs to be clear and where and how you document will reflect this. Discharging patients that are imminently dying is a challenge for most acute palliative care programs. You walk the line of appropriateness for continued acute inpatient care with the patient meeting acute criteria, vs. stable for discharge with ongoing care at different levels such as long term care vs. appropriateness for conversion to inpatient hospice in the hospital. At Mt. Carmel Health in Columbus, Ohio we have staff that have responsibilities with the acute palliative care service and with the hospice program. The hospice program is under the Mt. Carmel umbrella. Mt. Carmel is available to schedule a conference call to discuss this issue further if that would be helpful.

Response submitted by:
Sharol Herr, RN, MSEd, CHPN
Mt. Carmel Health System
Palliative Leadership Centers
Columbus, OH
VM: 614-234-0222 to schedule a call