The Hospice Guide
Can You Leave Hospice?
How to stop hospice, what happens if a patient improves, how to appeal a discharge, and how to return to hospice later.
Yes. A person can leave hospice at any time, and some people improve enough that they no longer qualify. Leaving hospice is not permanent: if their condition declines later, they can return to hospice care.
Choosing to stop hospice (revocation)
A patient, or their legal representative, can stop hospice at any time for any reason, for example to try a new treatment or return to the hospital for a procedure. To do this, they sign a statement with the hospice saying they are revoking the hospice benefit and the date it ends.
When hospice ends, regular Medicare coverage for the illness starts again. The person gives up any days left in that hospice benefit period, but they can elect hospice again later if they still qualify.
Being discharged because they improved
Sometimes a person’s condition stabilizes or improves on hospice. Good symptom control, regular nursing care and less stress can help. If the hospice doctor can no longer certify a life expectancy of six months or less, the hospice must discharge the patient. This is sometimes called “graduating” from hospice.
If this happens, the hospice should give advance notice, help plan the next steps, and connect the family with ongoing care such as the patient’s doctor, home health or palliative care.
Other reasons for discharge
- The person moves out of the hospice’s service area.
- The person transfers to a different hospice (allowed once per benefit period).
- In rare cases, safety issues in the home make care impossible.
If you disagree with a discharge
If the hospice says your loved one no longer qualifies and you disagree, you can ask for a fast appeal. The hospice must give you a written notice explaining how to appeal to the Quality Improvement Organization (QIO) for your area. Contact them right away, before services end.
Can people recover on hospice?
Hospice is for terminal illness, so a full recovery is uncommon. But some people do live longer than expected, and some improve enough to leave. Comfort-focused care, fewer hospital stays and support at home can make a real difference. This is one more reason not to wait too long to consider hospice.
Returning to hospice
If health declines again, the person can elect hospice again with the same hospice or a different one, as long as a doctor certifies they qualify. There is no limit on the number of times someone can return.
Sources
This guide is general information, not medical or legal advice.