Center to Advance Palliative Care

Within the past year our hospice, which is an extension of our local hospital, has started to do inpatient hospice. While I am not well versed in all of the infinite legal details that are involved with this transition yet, I can tell you a few things that we do. Upon recieving the referral from the hospital, we send a nurse and a social worker to do the initial referral. If the patient is unstable, symptoms are out of control (pain, SOB, etc), they are actively dying/changing and the family desires our services, then we can consider inpatient admission, upon our medical director's permission and a following physician. We change the patient's payer source from GIP to inpatient hospice. Admitting has to discharge the patient from the system and readmit them under a new account number. The nurse on the unit then completes an abbreviated admission that is called "discharge to another level of care" and then they follow our orders for hospice. The only catch is, we have to make sure everyday to document something that shows the patient still qualifies for inpatient care. If after 3-5 days, sometimes up to 7 days, they are not declining or showing that death is imminent, then we have to have a plan B for placement. I hope this helps you a little!