Hospice care is a specialized form of compassionate support focused on comfort and quality of life for individuals with a life-limiting illness. This care is an election of a benefit, not a permanent assignment to an agency, meaning patients maintain the right to direct their own care. Yes, you can switch providers, and the process is designed to be straightforward to ensure care aligns with the patient’s preferences and needs. Understanding the established procedures can provide a sense of control and reassurance during this sensitive time.
Understanding the Right to Change Providers
The patient’s ability to choose and change their hospice provider is a fundamental protection established under federal health guidelines. These rules recognize that the relationship between a patient, their family, and the care team is highly personal. This right ensures a patient can transition to a new agency if they are dissatisfied with the care or if they relocate outside of the current provider’s service area.
The ability to switch is not considered a “revocation” of the hospice benefit, which would temporarily end coverage; instead, it is a simple transfer of designation. This distinction is important because a transfer allows the patient to continue along the same benefit timeline without any break in coverage. Under Medicare guidelines, a patient has the right to change providers once during each established benefit period.
Hospice care is structured in benefit periods, beginning with two 90-day periods, followed by an unlimited number of 60-day periods, provided the patient remains eligible. Changing providers once within any of these specific periods is permitted and does not jeopardize the patient’s existing coverage. This ensures that insurance coverage, whether through Medicare, Medicaid, or private plans, remains intact during the transition.
The Step-by-Step Process for Switching Agencies
Initiating a transfer begins with the patient or their representative selecting a new hospice that better meets their needs, such as one with specialized services or a location closer to family. The patient must then formally notify both the current and the new hospice agencies of the planned change. This clear communication is necessary to ensure a seamless handoff.
This formal notification involves filing a signed statement with both the transferring and the receiving agencies. This document must clearly state the name of the previous hospice, the name of the newly designated hospice, and the precise date the change will become effective. The effective date is particularly important, as the transfer must occur immediately without a gap in service, which would otherwise be considered a discharge and re-admission.
The current provider is then required to facilitate the transfer promptly and cannot unreasonably delay the process. The receiving hospice completes a new election form to formally admit the patient under the same benefit period. Both hospices must coordinate the transfer date so that continuous coverage is maintained.
Ensuring Continuity During the Transition
A primary concern during any agency change is preventing a disruption in the patient’s comfort and care routine. Achieving a seamless handoff requires careful logistical coordination between the two providers. The receiving hospice must complete all necessary patient assessments required by regulatory conditions of participation to understand the current care plan.
The transferring hospice is responsible for forwarding a copy of the patient’s clinical record and a discharge summary to the new agency, ensuring that the new team has a complete medical history and current care notes. This record transfer is important for maintaining consistency in pain management and symptom control protocols. The patient’s attending physician must also be kept informed of the change to coordinate any necessary medical interventions.
Logistics surrounding medications and durable medical equipment (DME), such as hospital beds or oxygen concentrators, are also managed during this phase. The new hospice assumes responsibility for providing these items and ensuring the patient has an uninterrupted supply of necessary medications. Proactive communication with the new care team about personal preferences and daily routines helps ensure that the stability of personal care is maintained from the moment the transition is complete.