Terminate with care

Sunday, May 31, 2009

Q. How can we discontinue services to a patient and avoid liability for abandonment?

A. HME providers encounter a number of situations in which it may be necessary and/or appropriate to discontinue services to patients. Such situations may, for example, include threatened or actual violence, nonpayment or noncompliance

When providers discontinue services, they must take appropriate action to avoid liability for abandonment - defined as the termination of the provider/patient relationship by the provider without reasonable notice.

If the patient terminates the relationship, there is no liability for abandonment. There is also no liability for abandonment when a patient and provider mutually agree to terminate services. (Providers should seek mutual agreement when third-party insurers will not pay for needed services. If that occurs, ask the patient to pay out-of-pocket for the services. If the patient declines, the provider should document that decision.)

A good rule of thumb is that most services can be discontinued by giving the patient a notice of between one and three days.

Providers must verbally notify patients of the decision to terminate services, give the reasons for this decision and document that they have done so. If applicable, providers should verbally notify the patient’s attending physicians, other providers and case managers

Notice of termination should be given in writing and be hand-delivered to the patient via a staff member, courier, messenger or via overnight delivery service. It is not necessary to obtain patients’ signatures verifying receipt. If applicable, a copy of the notice of termination should be faxed to the patient’s attending physicians, other providers and case managers following delivery to the patient.

Elizabeth Hogue is a private practice attorney. Reach her at 877-871-4062 or elizabethhogue@elizabethhogue.net.