Discharge/Revocation/Transfer - The hospice must provide adequate and

Discharge/Revocation/Transfer - The hospice must provide adequate and appropriate patient/family information at discharge, revocation or transfer. 1. Discharge – The patient shall be discharged only in the following circumstances: a. The patient is determined to no longer be terminally Ill with a life expectancy of six months or less; b. Patient relocates from the hospice’s geographically defined service area; c. If the safety of the patient or of the hospice staff is compromised. The hospice shall make every effort to resolve these problems satisfactorily before discharge. All efforts by the hospice to resolve the problem must be documented in detail in the patient’s clinical record; and d. If the patient enters a non-contracted nursing home or hospital and all options have been exhausted (a contract is not attainable, the patient chooses not to transfer to a facility with which the hospice has a contract, or to a hospice with which the SNF has a contract), the hospice shall then discharge the patient. e. The hospice must clearly document reasons for discharge. 2. Revocation – Occurs when the patient or representative makes a decision to discontinue receiving hospices services: a. A recipient may revoke hospice care at any time; b. If a patient or representative chooses to revoke from hospice care, the patient must sign a statement which states that he or she is aware of the revocation and stating why revocation is chosen. The effective date of discharge cannot be earlier than the signed revocation date. 3. Non compliance – When a patient is non-compliant, the hospice must counsel the patient/family on the option to revoke and any advantages or disadvantages of the decision that is made. A patient is considered non-compliant if: a. The patient seeks or receives curative treatment for the illness; b. The patient seeks treatment related to the terminal illness in a facility that does not have a contract with the hospice; or c. The patient seeks treatment related to the terminal illness that is not in the POC, or is not pre-approved by the hospice. 4. Transfer – The hospice must document the reason for such transfer and an appropriate discharge plan/summary is to be written. Appropriate continuity of care is to be arranged prior to such transfer.