Referrals & Admission

To be eligible for hospice services, all of the following apply:

1. The patient has a terminal illness
   
   
2. The patient has a life expectancy of 6 months or less if the terminal illness runs its normal course
   a. As determined and certified by two physicians (typically, the attending physician and the Hospice Medical Director)
   
   
3. There is a need for palliative services to manage the terminal illness
   a. Examples: symptom control, psychosocial support, advance care planning, spiritual care, DME needs, grief and loss issues, bereavement support
   
   
4. The patient or designated agent elects to use the hospice benefit in place of traditional insurance coverage for medical care related to the terminal illness
   a. Hospice is a voluntary program appropriate when a comfort care approach toward management of the terminal illness is desired
   b. Some private insurers (NOT Medicare or Medicaid) will pay for both hospice care and traditional medical care – check with the insurance company for benefit information
   c. Children receiving care through Medicaid are eligible to receive concurrent curative care and hospice care through the Affordable Care Act

Initial referrals are accepted from the primary physician, social worker, nurse, patient, family, or any other participants in the patient's care.

Referrals and information consultations are available at no charge.

These are the steps undertaken to begin a referral:

• Contact Hospice of Mercy at (319) 398-6850.
• Be prepared to provide initial information on the patient's diagnosis, prognosis and needs. The physician will be contacted for approval of admission to Hospice of Mercy, and to give further orders or a reason for not admitting the patient to the hospice program.
• Hospice of Mercy will arrange a referral visit at the hospital before discharge, at the patient's home or at the nursing home. In most cases, this can take place within 24 hours of the initial referral.
• A consultation will be encouraged early in the patient's treatment process to provide them information about hospice services. This may ease the patient's transition to hospice care if the disease becomes terminal.

• The prognosis is limited.
• The focus of care is on comfort.
• The patient and family know about the diagnosis and consent to hospice services.
• The patient lives in our service area.
• The patient and family know and accept that hospice is primarily home care.