Myth #1:

When I refer patients to Hospice they die quickly.

Fact #1:

The average length of stay in Hospice is 69 days nationwide. Many patients are referred in their very last days of life, and as a result, the myth is often accurate. However those patients that are referred earlier in their disease progression may live longer with early palliative care.
"The New England Journal of Medicine." 363 (2010):733-742.

Patients and families often report that they wish they had been referred to hospice sooner.

National data indicates that patients referred earlier in their disease process actually live longer and have a better quality of life and have a better death experience.

Myth #2:

Hospice just gives patients pain medication.

Fact #2:

Hospice supports many palliative therapies to help patients meet symptom management as well as comfort goals.

Myth #3:

I can get in trouble with Medicare if I refer a patient to Hospice and their service extends beyond a 6 month period.

Fact #3:

Referral criteria include a "6 month prognosis if the disease runs its normal course."

The referring or attending MD is at no risk for Medicare penalties if the patient lives longer than 6 months. Hospice medical directors are required to complete a face to face visit with all hospice patients entering their third benefit period (usually occurs around 6 months) every 60 days to re-certify them as continuing to be eligible for the Medicare hospice benefit.

If a patient’s condition improves and they are no longer eligible they can be discharged from hospice and re-admitted if their disease progresses.

Myth #4:

A patient has to have cancer to be in Hospice.

Fact #4:

Any terminal illness with 6 months or less prognosis, will qualify a patient for hospice eligibility.

Hospice is an excellent program for any patient facing a terminal illness or a combination of co-morbidities that add up to a terminal prognosis.

In addition to disease specific guidelines, consider Hospice for any patient with a decline in status, increase in ADL needs, multiple hospitalizations, multiple ER visits, unexplained weight loss, difficulty getting to appointments, and increasing caregiver stress.