When Hospice Live Discharges Deserve a Closer Look

Many people see a live discharge as just the end of hospice care, but it often means a big change for patients and their families. When patients leave hospice, they may suddenly lose access to medications, equipment, and the support they depend on. Their care might also move to providers who do not know their goals or history. Kathy Ahearn points out that these changes matter for both patients and hospice agencies. CMS reviews live discharge data to assess quality and performance, and high rates can attract extra scrutiny during reviews.

Every hospice should expect some live discharges. Patients can choose to stop hospice care. Some move, switch to another hospice, or have changes in their health that affect eligibility. These are all normal parts of hospice work.

The main issue is not that live discharges occur, but whether an agency’s rates are much higher or begin to differ from those of similar organizations.

CMS checks these patterns because they can sometimes show bigger problems, such as:

Ahearn stresses that the aim is not to get rid of live discharges. Instead, it’s important to understand why they happen and see if your agency’s trends need a closer look.

Many hospice leaders focus on being ready for surveys and following rules, but live discharges also affect quality reporting. CMS tracks several quality measures tied to live discharges, such as early or late discharges and difficult transitions that lead to hospital stays after hospice. These measures help show how well agencies support patients during hospice care. Reviewing live discharge data for quality improvement, not just compliance, can help agencies find ways to improve patient care, make admissions stronger, and cut down on avoidable problems.

Instead of asking, "Do we have live discharges?" try asking: "Do we understand why our live discharges are happening?"

Watching these patterns over time can help spot trends before they turn into bigger problems. Even agencies with good overall rates might find ways to make admissions, documentation, patient education, or discharge planning more consistent.

This article covers only one part of hospice live discharges. In the full webinar, Hospice Live Discharges: The Who, What, When & How, Kathy Ahearn explains the five allowed reasons for live discharge under the Conditions of Participation, how CMS checks hospice performance, common compliance issues, coding rules, quality reporting, and practical tips to improve your agency’s live discharge process.

If you work in hospice compliance or quality improvement, the full webinar gives a much deeper look at this important topic.