Woman Loses Hospice Care Because She’s Lived Longer Than Expected

Image courtesy of MeneerDijk

When someone is receiving hospice care, it usually means they’re very close to the end of their life. But what happens if that person simply refuses to die?

A woman who’s outlived her prognosis has lost hospice care for that very reason, CBS New York reports. She wasn’t supposed to still be alive, after doctors gave her less than six months to live… two years ago. But despite battling stage 4 lung cancer and chronic obstructive pulmonary disease, she’s hanging in there.

“I’m not going to die – I’m assuming I’m not going to die,” she told CBS New York.

She had been staying mostly on her daughter’s couch, with drugs, oxygen equipment, and a weekly nurse’s visit paid for by Medicare.

“Bottom line — she’s not dying fast enough. That’s the bottom line,” her daughter told the station. “I received a phone call last week: ‘We had a meeting. We decided she’s stable, and we’re pulling hospice,’” she explained, saying they didn’t offer an alternative.

Medicare rules define hospice care as for the actively dying only, and “terminal” means you have less than six months to live. Now that her hospice provider has done what’s called “graduating” the woman from hospice care, she’ll have to go back to her private doctor and supplemental insurance.

But some experts say that “six months or less” rule shouldn’t always apply.

“If the patient is in a gray zone where they’re not necessarily declining but they don’t look good, in my opinion, that patient’s a hospice patient,” said Dr. Mark Fialk of Hospice of Westchester, told CBS NY, noting it’s “very much” a judgment call.

Anyone removed from hospice care has the right to appeal directly to Medicare. And while some patients may end up returning to hospice care at that point, it can be very inconvenient to go through the experience of switching doctors when they’re feeling that sick.

“People should be aware that this can happen to them,” the woman’s daughter says.

Woman Loses Hospice Care After Living Longer Than Expected [CBS New York]