{"ref":"TX-HSP-DC-01","title":"Discharge, Transfer and Discharge for Cause","category":"Hospice care","summary":"Sets out the only reasons the Agency may discharge a patient, the steps required before a discharge for cause, the physician discharge order, discharge planning for patients who are no longer terminally ill, the Texas written notice and its timing, the Medicare notice of non-coverage and notice of termination, the discharge summary, and transfers to other providers.","inShort":["We can discharge a patient only if they move away or go to another hospice, are no longer terminally ill, or for cause after every required step.","Never discharge a patient because their care is costly or because they use the services they need.","Before a discharge for cause, tell the patient it is being considered, try hard to fix the problem and write everything down.","The medical director must sign a written discharge order first. Ask the patient’s own doctor for input.","Hand the written notice to the patient at least five days before discharge. Medicare patients who are no longer terminally ill also get the Medicare notice at least 2 days before.","Send the discharge summary to the patient’s doctor or the new provider."],"primaryCitation":"42 CFR §418.26","citations":["26 TAC §558.859","26 TAC §558.295","26 TAC §558.220(j)-(k)","26 TAC §558.301(a)(9)(N)","26 TAC §558.281(2)","Tex. Hum. Res. Code §102.003(r)"],"federalCitations":["42 CFR §418.26","42 CFR §418.104(e)","42 CFR §405.1200","42 CFR §405.1202","42 CFR §418.24(f)"],"surveyorAsks":["Why was this patient discharged? Show me the written physician discharge order and the attending physician’s input.","This patient was discharged for cause. Show me that you advised the patient, tried to resolve the problem, checked it was not about use of necessary services, and documented it."],"forms":[{"ref":"TX-HSP-DC-01-A","title":"Notice of Hospice Discharge or Transfer"},{"ref":"TX-HSP-DC-01-B","title":"Hospice Discharge Summary"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.26; 26 TAC §558.859, §558.295)","5. Reasons for Discharge","6. Discharge for Cause","7. Discharge Planning When the Patient Is No Longer Terminally Ill","8. Physician Discharge Order","9. Notices","9.1 Texas written notice (26 TAC §558.295)","9.2 When advance notice is not required","9.3 Medicare notice of non-coverage","9.4 Notice of termination to the Medicare contractor","10. Discharge Summary and Records","11. Patients Leaving the Service Area","12. Effect of Discharge","13. Responsibilities","14. Records and Compliance Monitoring","15. Staff Training","16. References","17. Related Policies and Forms","18. Approval","19. Revision History"],"version":"1.0","sample":false,"pack":"tx-hospice","state":"Texas","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 Hospice","legalName":"Sample Hospice, LLC","logo":null}}