Prognosis: First, there is a technical requirement that the doctor must give a prognosis of six months or less. Prognosis only means an estimation to the best extent that doctors can make such estimates. The prognosis a doctor will give will be based on the concept that a patient continues to receive the best, curative therapies available. The doctor believes that there is a probability that with the best curative treatments available, a patient may have six months or less. The confusing aspect of the prognosis requirement is that patients who enroll in hospice in a timely fashion tend to live longer than patients who only seek curative treatment and who do not enroll in hospice. If a patient needs home care for longer than six months, Medicare and other payors will usually continue to authorize hospice care so long as the doctor's prognosis continues to be six months. Patients who remain stable for a long time are considered "hospice graduates," and are returned to normal medical care.
Curative Treatments: By Medicare regulation, the hospice benefit is for people who are not receiving treatments that are intended as curative. This means that patients who enroll with LifeCare hospice typically have no known treatment options that will do more good than harm. This may also mean that patients have begun expressing goals of avoiding discomfort and the rigors of emergency room and inpatient treatments. Situations change, and LifeCare hospice does not ask you to switch to a hospice doctor. Patients who enroll with LifeCare hospice have the right to be discharged and continue curative treatments at any time.
Homebound: Hospice patients are not required to homebound. This is often an area of confusion, because homebound is a home health requirement. However, homebound is not a hospice requirement. In fact, hospice patients may be relatively active as long as they meet the two criteria above.