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Letter to the Editor: Medicare and Hospice

The following is a letter to the editor submitted by Nerice Kaufman, the Executive Director of Carlsbad-based Hospice of the North Coast.

As a longtime hospice professional and Executive Director of the nonprofit, Carlsbad-based Hospice of the North Coast, I wish to address the confusion circulating about Medicare’s ostensible six-months-or-less-to-live mandate in providing hospice care benefits. In the wake of San Diego Hospice’s well-publicized troubles, Southern California hospices have been deluged by families concerned about the ability of loved ones to have a peaceful life-through-death experience.

Medicare recognizes that the exact progression of an illness cannot be predicted. (In fact, due to the compassionate integrated care they receive, a small percentage of our clients “flunk” hospice and are discharged.)

When terminally ill patients outlive their six-month prognosis but continue to decline, they can be recertified to remain on hospice and continue receiving Medicare benefits. As hospice professionals, our responsibility is to accurately and meticulously chart each patient’s progression to attain both patient advocacy and full compliance.

Nationally, the vast majority of terminally ill patients – often due to futile medical efforts – may spend only a few days or weeks on hospice, greatly diminishing their quality of life while not extending the quantity of their life. At hospice, our primary concern is providing palliative care within a holistic framework of support that enables people to die with dignity, comfort and grace. Whether that means six weeks, six months or more, we are there for them, and so are their Medicare benefits.

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