{"ref":"DC-HSP-ELC-03","title":"Revocation, Change of Designated Hospice and Change of Attending Physician","category":"Hospice care","summary":"Sets how a patient or representative revokes the hospice election, changes to another hospice once in a benefit period, or changes attending physician; what each signed statement must say; that only the patient or representative can revoke; and what the Agency then does for continuity of care, records and Medicare notices.","inShort":["Only the patient or representative can revoke hospice care. Never suggest it to avoid costs.","Revocation needs a signed statement with an effective date no earlier than the date it is made.","A patient may change hospices once in each benefit period; this is not a revocation.","To change attending physician, the patient signs a statement naming the new physician and the date.","Tell the registered nurse coordinator the same day if a patient talks about leaving hospice."],"primaryCitation":"42 CFR §418.28","citations":["29 DCMR §939.14","29 DCMR §939.15","29 DCMR §940.12"],"federalCitations":["42 CFR §418.28","42 CFR §418.30","42 CFR §418.24(h)-(i)","42 CFR §418.104(e)","42 CFR §418.52(c)(4)"],"surveyorAsks":["Show me a revocation statement. Is the effective date on or after the date it was signed?","How do you make sure staff never encourage a patient to revoke?"],"forms":[{"ref":"DC-HSP-ELC-03-A","title":"Revocation of the Hospice Benefit"},{"ref":"DC-HSP-ELC-03-B","title":"Change of Designated Hospice"},{"ref":"DC-HSP-ELC-03-C","title":"Change of Attending Physician"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.28(a))","5. When a Patient Talks About Leaving Hospice","6. Revoking the Election","7. Effects of Revocation","8. Changing to Another Hospice","9. Changing the Attending Physician","10. Responsibilities","11. Records and Compliance Monitoring","12. Staff Training","13. References","14. Related Policies and Forms","15. Approval","16. Revision History"],"version":"1.0","sample":false,"pack":"dc-hospice","state":"Washington, DC","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}