What is the purpose of a Hospice Waiver?

Many of us are very frustrated with recent State of California statewide requirements for exceptions for hospice care in assisted living.  The whole idea behind the original Hospice Waiver was to eliminate the need for numerous exceptions.  Providers must now have an exception for:

1.  Any “prohibited” conditions such as the progression of a pressure sore from stage 2 to stage 3.

2.  Any resident who is “total care” meaning the resident requires assistance with all activities of daily living.  The majority of residents get to this point during the last days of life.

I understand where licensing is coming from.  They are trying to ensure that dependent residents receive appropriate care.  While the vast majority of providers provide outstanding care, there are those that are in over their heads when complexities of care such as these arise.  However, this exception method is burdensome not only to providers, but also to CCL staff who are already spread so thin.

To remain compliant, please be aware of the need to apply for these exceptions.

2 Responses to “What is the purpose of a Hospice Waiver?”

  1. I guess this is a conflict of interest. I’ve always thought that the rights of the patient are more important than whatever licensing thinks of what is appropriate care. Before patients are admitted to hospice, patient and/or the family are made aware of the situation at hand and what may happen in the future, be it better or worse. It is expected that these patients may in one time be in the state of having pressure ulcers (due to poor nutrition, low albumin level, etc) and/or be in need of maximum assistance. Therefore, what is the goal of transferring a patient to a nursing facility? Is it to cure or for comfort? I think it would be more stressful for patients to be transferred from one place to another per se and just the idea of being in a foreign environment is a great factor for anxiety. It is also very stressful for the family as they have come to trust the caregivers in the board and care. What then is the worth of a Hospice Waiver? What is so wrong of putting your loved ones in a board and care that create a semblance of home, wherein they are also being taken care of? Does the patient/family no longer have a say where they want their loved ones to pass away? I’m so confused. Can someone please explain to me like I’m a 5 year old?

  2. Eric, I am in total agreement with you! Did you find a solution? Please contact me…I am facing the same dilemma.
    Also, anyone else who has been through this. Thank you, Elena

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