{"ref":"MO-HSP-ELC-03","title":"Revocation, Change of Designated Hospice and Change of Attending Physician","category":"Hospice care","summary":"Sets out how a patient or legal representative may end hospice care at any time by revoking the election, change the designated hospice once in each benefit period, or change the attending physician; the signed statements each requires under Medicare and MO HealthNet; effective dates; the notice of termination or revocation filed within five calendar days; the information sent to the attending physician and to a new hospice; and the Agency's rule that staff never pressure a patient to revoke.","inShort":["A patient may stop hospice care at any time. Never encourage or pressure anyone to revoke.","Revocation needs a signed statement. The effective date can be the day of signing or later, never earlier.","Tell the attending physician every time hospice care ends, and write it in the record.","A patient may change to another hospice once in each benefit period. Send the new hospice the medication profile, advance directive, current problems and plan of care.","A change of attending physician needs a signed statement naming the new doctor and saying the change is the patient's choice."],"primaryCitation":"42 CFR §418.28","citations":["19 CSR 30-35.010(1)(D)1, 2, 4","19 CSR 30-35.010(1)(A)1","13 CSR 70-50.010(3)(B)3.C-D","13 CSR 70-50.010(3)(C)","RSMo §197.264.1"],"federalCitations":["42 CFR §418.28","42 CFR §418.30","42 CFR §418.24(h)-(i)","42 CFR §418.52(c)(4)","42 CFR §418.104(e)(2)"],"surveyorAsks":["Show me this patient's revocation statement. Is the effective date on or after the date it was signed?","Was the attending physician notified of the discontinuance, and where is that documented?"],"forms":[{"ref":"MO-HSP-ELC-03-A","title":"Statement of Revocation of the Hospice Benefit"},{"ref":"MO-HSP-ELC-03-B","title":"Change of Designated Hospice or Attending Physician"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (19 CSR 30-35.010(1)(D)1; 42 CFR §418.28)","5. No Pressure to Revoke","6. Revocation","6.1 After a revocation","7. Change of Designated Hospice","8. Change of Attending Physician","9. Re-election","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":"mo-hospice","state":"Missouri","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}}