Hospice care is designed to provide terminally ill individuals with the support they need to comfortably reach the end of life. One of the most comforting aspects of hospice is that services are provided wherever a Fremont patient calls home. But what happens in the event of an emergency? Can a hospice patient go to the hospital?
To answer those questions, the context of the situation must be considered. As a matter of course, those under hospice care are discouraged from seeking outsider care. Hospice services are geared toward relieving pain and other troubling symptoms, thereby improving patient comfort and quality of life. The plan of care is personalized to meet the individual’s unique needs, and whenever necessary, the plan can be modified. As a result, hospice patients rarely need to visit the hospital.
That said, when a patient has an urgent medical need that cannot be addressed in the home setting, a hospital visit may be covered. However, this is typically only the case if the issue is unrelated to their terminal illness. Read on to learn more.
Valid Reasons for Visiting a Hospital
Life is unpredictable. Like anyone else, hospice patients are at risk of contracting new illnesses and sustaining injuries like concussions, torn ligaments and broken bones. When someone in hospice develops a new condition or incurs a serious injury, a hospital visit may be warranted.
Still, patients and their family caregivers need to be conscious of the difference between discomfort related to the progression of a terminal illness and a real emergency. Sometimes, such as in the event of a slip-and-fall accident or a severe burn, the need for urgent medical attention is obvious. At other times, the situation isn’t so clear. Hospice care providers do their best to ensure everyone is able to recognize typical symptoms, but when there’s any question, contacting the hospice care team is recommended.
Navigating a Medical Crisis in Hospice Care
For the average Fremont resident, experiencing pain or worsening symptoms might be a reason for a trip to the hospital. With a hospice patient, that shouldn’t be the first course of action.
Instead of calling for an ambulance or heading to the hospital, contacting the hospice care team is imperative. In most cases, the costs of ambulance transportation, emergency room care and care received as a hospital inpatient aren’t covered by Medicare, Medi-Cal or private insurance. The only exceptions are when a patient needs urgent care for a reason unrelated to their terminal illness and when the hospice team makes the arrangements for hospitalization.
Quite often, though, a call to the hospice care team doesn’t result in authorization for a hospital visit. The more common strategy for dealing with a medical crisis is to arrange for continuous home care, with around-the-clock support provided by registered nurses. When required, a patient may be transferred to a dedicated hospice facility or a Fremont hospital, but making it a temporary stay is the goal, and once the individual is stable, they go back home.
When Hospital-Based Services Aren’t Covered
Every hospice patient in Fremont needs to be aware that medical services related to their terminal illness must be provided by or arranged by the hospice care team. Visiting a physician who isn’t part of the team or receiving treatment at a local hospital can result in services being revoked.
Furthermore, when the proper procedure isn’t followed – meaning that a hospice patient in need of urgent care calls for an ambulance or heads to the hospital – the costs usually aren’t covered by Medicare, Medi-Cal or private insurance.
In an actual emergency, contacting the hospice team is the right move. When a hospice nurse contacts emergency services, they provide the right medical code for coverage. They also provide details on the patient’s medication, as that can prevent drug interactions. Also, the nurse will make it known that the individual is in hospice care so the hospital staff doesn’t make any attempts attempt to treat their terminal illness.
Hospice Care is Always a Choice
When someone decides to enter hospice care, they can change their mind at any time. If a new treatment for their illness becomes available or the patient simply wants to resume the search for a cure, they can discontinue hospice services – and the decision doesn’t have to be final.
A patient who chooses to leave hospice care can return later on if they like, provided they meet the eligibility criteria. As long as a physician certifies that the individual is terminally ill and has a prognosis of six months or less, Medicare, Medi-Cal and most private insurance plans allow for reactivation of hospice care services. In this situation, patients can either opt for services from their original care provider or switch to a different Fremont hospice agency.
Do you have questions? Or would you like more information on hospice care? The professional team at Suncrest Hospice of Fremont would be happy to help – and you can give us a call, reach out online or arrange for an in-person consultation. Contact us today!
