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The hospital can request patient to sign to go to hospice, but can NOT make the patient sign to go to hospice.
This is directly from the Medicare and You 2009 book concerning Hospice Care: For people with a terminal illness who are expected to live 6 months or less (as certified by a doctor). Coverage may include drugs (for pain relief and symptom management), medical, nursing, social services, and other covered services as well as services not usually covered by Medicare (like grief counseling). Hospice care is usually given in your home (or other facility like a nursing home) by a Medicare-approved hospice. Medicare covers some short-term inpatient stays (for pain and symptom management that requires an inpatient stay) in a Medicare-approved facility, such as a hospice facility, hospital, or skilled nursing facility. Medicare also covers inpatient respite care (care given to a hospice patient so that the usual caregiver can rest). You can stay in a Medicare-approved facility up to 5 days each time you get respite care. Medicare may pay for covered services for health problems that aren't related to your terminal illness. You can continue to get hospice care as long as the hospice medical director or hospice doctor recertifies that you are terminally ill. You can view the entire book here: http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf
WHEN MEDICARE IS PRIMARY, THE PATIENT IS RESPONSIBLE FOR THE SECONDARY COPAY.
One limitation of present hospice models is that most require physicians to estimate that the patient is not likely to live longer than six months. This requirement is related to criteria for Medicare eligibility
In the US, hospices are paid in the same manner as hospitals, nursing homes, and home care.Depending on the patient's or family's type of insurance and financial ability to self-pay, healthcare first would use in this order: Self-pay, then Private Insurance, then Federal Medicare, then State Medicaid. IF one of these is not available (for example, the patient has no ability to pay), it skips to the next source in the list. There may be co-pays for Private Insurance, Federal Medicare, or State Medicare; co-pays vary by State and by income. The patient or patient's family are required to pay the co-pays. Also, under State Medicaid, a family may be required to sign over the patient's assets (example: their home).
If the script says hospice, it should be for a hospice patient.
Some will let you do that each state has its own rules and regulations when it comes to agency like the ones you mentioned hospice takes allot of care with home health they do allot of the same things that hospice does i would think that if the patient wanted it they would try and follow that request
Yes, a LPN can legally administer narcotics to a hospice patient.
As far as I know, only one doctor needs to certify a patient for hospice, and it can be the patients doctor that does this. I've work with hospice for 20 years, and in that 20 years I've never heard that it took two doctors or just the medical director with hospice to certify a patient to be enrolled in the hospice care program. The patient does hwoever need to be deemed terminal for the hospice care program to be considered.
Hospice workers go to homes because the hospice patient prefers to be at home to die, instead of a hospice house.
The doctor must certify for a patient to go into hospice, but anyone can call hospice for information that is in the system
The hospice patient probably would have pain if not given the pain meds, so it is to keep the pain at bay.