The Hospice Benefit Runs in Periods. Know What Paper Should Be on File for Each One

Hospice is not an open account that stays open on its own. The federal hospice rule organizes coverage into benefit periods, and each period needs a physician's certification in the record before the hospice bills for it. You do not sign that certification, and you do not decide what the physician concludes. But you are often the one in the house when a page is missing, a nurse changes, or the schedule shifts, so it helps to know what should be on file and what to ask for.

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What should be on file

Ask the hospice for a copy of the current plan of care, the date of the most recent physician certification, and the date the current benefit period began. Ask who signs the certification for each new period, how the physician is reached if the signature is late, and what the hospice does in the meantime. You are not asking the hospice to explain the illness. You are asking where the paper is and who keeps it moving.

Keep your own record

Write down the dates the hospice gives you, the name of the nurse who gave them, and the night number. Keep the page where you will look for it. Each time a visit changes the plan, note what changed and when, so you can match the next paper against it. A recertification that comes with a change in the plan of care is a good time to ask the nurse to explain the change in terms of what will be different in your home this week, such as which visits move, which supplies arrive, or who is in charge at night.

What the paper does not cover

The benefit pays for the hospice team's visits, equipment, and supplies that fall under the hospice plan. By itself, it does not pay for the hours between scheduled visits, and the paperwork will not tell you who is awake at 2am. That gap is yours to plan, and the paperwork is only useful if you know which page belongs to which part of the care. For the rule itself and the sources behind it, see Sources.