death certificates...hospice and 911

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coffeehubcap
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death certificates...hospice and 911

Post by coffeehubcap » Mon Jun 11, 2018 5:09 pm

If you die at home and call 911 who issues the death certificate? If you're in hospice who issues the death certificate.

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dm200
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Re: death certificates...hospice and 911

Post by dm200 » Mon Jun 11, 2018 5:17 pm

coffeehubcap wrote:
Mon Jun 11, 2018 5:09 pm
If you die at home and call 911 who issues the death certificate? If you're in hospice who issues the death certificate.
Presumably you either call 911 BEFORE you die OR someone else calls 911 after.

Why does it matter?

mrb09
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Re: death certificates...hospice and 911

Post by mrb09 » Mon Jun 11, 2018 5:23 pm

When we went through this with my mom, we were instructed by Hospice to call them rather than 911. They had someone on call.

PhilosophyAndrew
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Re: death certificates...hospice and 911

Post by PhilosophyAndrew » Mon Jun 11, 2018 5:23 pm

My Dad died during home hospice.

His primary care physician — who also owned the hospice company he used — was present when he died and called the funeral home to pick up his body.

The doctor competed and signed the death certificate, the state issued it, and the funeral home had twenty copies for me the day after his funeral. (That turrned out to he more than we needed, but they were inexpensice and I’d rather have had too many than too few.)

There was no need to call 911.

Andy.

curmudgeon
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Re: death certificates...hospice and 911

Post by curmudgeon » Mon Jun 11, 2018 5:33 pm

It can be a bit messy. I think hospice *should* have a process for ensuring that you get a death certificate. Ask them in advance. If you call 911, it may depend on the capabilities of your local emergency responder; some might have to transport to the hospital for an official declaration.

It was a bit of a headache when my mom passed (at age 89). When she weakened dramatically, she didn't want to be in the hospital, so we stayed with her the last several day at her apartment in a senior living facility. When she died, the RN from the associated nursing home came over and confirmed she was dead; in this circumstance, 911 didn't want to send a crew out (major metro area), and the mortuary (out of town, working with a local service) didn't have a process either. In the end her MD did the death certificate (which got kicked back by the county coroner once), and it all worked out, but we almost had to delay the burial.

For us, letting Mom die in her own place was good, but we probably should have just pushed the 911 process when she actually died (said we came back into the room and she was unresponsive) despite the commotion and waste of an emergency call.

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Re: death certificates...hospice and 911

Post by bayview » Mon Jun 11, 2018 5:56 pm

Typically, in these circumstances (expected death), the death certificate is done by the primary care provider or by the physician who ordered hospice care.

That person is rarely the one who pronounces death, but s/he is familiar with the patient’s medical condition and can therefore render the opinion of cause of death.
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Re: death certificates...hospice and 911

Post by 123 » Mon Jun 11, 2018 6:05 pm

Generally, the entity handling the body, funeral home/crematorium, is responsible for preparation of the death certificate and filing it with the county/state. They are motivated to prepare it because in most jurisdictions, they cannot bury or cremate a body, until a death certificate, is established. In routine cases the treating physician of the deceased, which can include a hospice physician, will be contacted to specify a cause of death. If a treating physician cannot declare a presumed cause of death there may be an autopsy by the county/state. Autopsy is also done if the death is non-routine.
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rocdoc1
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Re: death certificates...hospice and 911

Post by rocdoc1 » Mon Jun 11, 2018 6:06 pm

If someone is in "hospice", the expectation is death within 6 mos. A physician has to document that and remains responsible for the care during that period. When the person dies, it is an expected event and therefore, the doctor in charge fills out the death certificate. Typically when one enters hospice, they are instructed not to call 911, the care is at home and take care of by the hospice team. A nurse often has the ability to pronounce the patient at home.

2015
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Re: death certificates...hospice and 911

Post by 2015 » Mon Jun 11, 2018 6:17 pm

rocdoc1 wrote:
Mon Jun 11, 2018 6:06 pm
If someone is in "hospice", the expectation is death within 6 mos. A physician has to document that and remains responsible for the care during that period. When the person dies, it is an expected event and therefore, the doctor in charge fills out the death certificate. Typically when one enters hospice, they are instructed not to call 911, the care is at home and take care of by the hospice team. A nurse often has the ability to pronounce the patient at home.
Exactly what I have been told by the hospice team that I'm using for care oversight now. I have been specifically told by the former PCP that once the individual enters hospice their office is no longer involved. The funeral home provided excellent information regarding navigating death certificate issues in that state.

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Re: death certificates...hospice and 911

Post by LadyGeek » Mon Jun 11, 2018 6:49 pm

This thread is now in the Personal Finance (Not Investing) forum (death certificate).

This is what exactly happened to my Dad when he passed away at home a few years ago. The funeral home refused to take him unless we had a signed statement from a qualified medical person. :shock:

So, we called 911 and explained the situation. No problem, happens all the time. They sent the paramedics. Since a death was involved, the police came as well.

The officer made a quick call to the Medical Examiner's office and straightened things out (no... this is not a crime scene). It didn't hurt that I had a copy of my Dad's physician report in-hand stating his poor prognosis.

The EMTs and the officer signed off on the paperwork and we were able to proceed as planned.
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Re: death certificates...hospice and 911

Post by Katietsu » Mon Jun 11, 2018 7:03 pm

The appropiate procedure is going to depend on your locality. Talk to the hospice provider. In my experience, if death is anticipated within 24 hours, they will provide almost constant nursing staff if you wish. The hospice staff will coordinate with the funeral home. In one situation where hospice was not involved and EMT arrived, the EMT called the PCP who said he was willing to sign the death certificate. The EMT's called the funeral home who came to the house of the deceased. If the PCP was not willing to sign the death certificate, the EMTs would have to involve the medical examiner.

You will need to identify a funeral home in advance. I know I was surprised at how I needed to immediately provide this information.

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Re: death certificates...hospice and 911

Post by cheese_breath » Mon Jun 11, 2018 8:53 pm

MIL died in hospice in our home almost two years ago. DW's daughter's family had come from Texas and was staying with us because they knew the end was imminent. At the end we were giving her morphine every two hours. I found her dead when it was my turn at 3:00am. First I woke DW so she could spend a couple minutes alone with her mother, then I woke the family and phoned DW's sons and brothers. Only after that did I phone hospice, and they took care of getting everyone else there... nurse, doctor, police, funeral home. And yes, we had previously told hospice which funeral home we would be using. I don't remember everything, but I do remember the nurse inventorying and disposing of the remaining morphine, and the doctor conversing with the policeman to assure him it was a natural death and then completing the death certificate. We obtained our copies a few days later from the funeral home who had obtained them from the county.
Last edited by cheese_breath on Mon Jun 11, 2018 8:55 pm, edited 1 time in total.
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Re: death certificates...hospice and 911

Post by RetiredCSProf » Mon Jun 11, 2018 8:54 pm

My Mom was in hospice care at assisted living when she passed away at age 99. She had been in hospice care for only a few days, but had their caretakers round the clock. The hospice staff left soon after my Mom's passing and had nothing to do with making arrangements with the mortuary or funeral home. I don't remember who signed the death certificate, but I think it may have been the mortuary.

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Re: death certificates...hospice and 911

Post by Sagefemme » Tue Jun 12, 2018 12:11 am

My mom died at home in 2015 after being in hospice for about two months. Hospice advised me to call the mortuary in advance to start arrangements. When I called them I imagined she would live at least a few more weeks; in fact she died a few days later. No one "pronounced" her dead. I and my daughter and an unlicensed caregiver were present. We didn't call anyone for a while. My daughter and I spent some quiet time with the body and then called the mortuary who came within two hours and picked her up. My mom's doctor, who she had not seen in a few months, signed the death certificate and I assume listed the cause(s) of death which of course were the diseases that plagued her the last few years of her life. When an expected death happens at home with hospice involved, I think it can all be pretty calm and involve no 911 calls. But it may vary depending on what state you live in.

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Re: death certificates...hospice and 911

Post by gsmith » Tue Jun 12, 2018 2:29 am

coffeehubcap wrote:
Mon Jun 11, 2018 5:09 pm
If you die at home and call 911 who issues the death certificate? If you're in hospice who issues the death certificate.
In IL, the funeral home enters the biographical information in, and a doctor (either the PCP, hospice, or nursing home doctor), can enter the cause of death and e-sign.

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Re: death certificates...hospice and 911

Post by mrc » Tue Jun 12, 2018 4:05 am

With my MIL, hospice emphasized to call them, and do not call 911. The role of 911/EMS is to revive with extraordinary means if necessary, which is counter to the hospice objective. Dying at home (or in a hospice care facility, but not a hospital) is a process—the hospice folks orchestrated every step. The major advice was DO NOT CALL 911.
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Re: death certificates...hospice and 911

Post by JoeRetire » Tue Jun 12, 2018 5:59 am

coffeehubcap wrote:
Mon Jun 11, 2018 5:09 pm
If you die at home and call 911 who issues the death certificate? If you're in hospice who issues the death certificate.
When my mom passed away in January, she was at home. We had already engaged hospice. They arranged the death certificate process, but the actual pieces of paper came from the funeral home.

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Re: death certificates...hospice and 911

Post by Hillview » Tue Jun 12, 2018 6:07 am

death certificate comes from the funeral home -- my neighbor died last fall and the funeral home came to get him -- no 911.

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Re: death certificates...hospice and 911

Post by tibbitts » Tue Jun 12, 2018 6:51 am

I don't believe hospice had anything to do with the death certificate in the case I'm familiar with. Frankly hospice was very helpful until death and then things went downhill fast. Their overriding consideration was accounting for and destroying (an hours-long process) every drug. I found that when hospice is involved the funeral home won't touch the body for hours until that last vial of whatever is found. If you're missing any drugs I guess you're stuck with the body for life (yours, not the deceased's.)

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Re: death certificates...hospice and 911

Post by carolinaman » Tue Jun 12, 2018 7:07 am

My mother died in hospice at a nursing home. The hospice agency had a doctor who did the death certificate.

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Re: death certificates...hospice and 911

Post by Scrapr » Tue Jun 12, 2018 7:19 am

tibbitts wrote:
Tue Jun 12, 2018 6:51 am
I don't believe hospice had anything to do with the death certificate in the case I'm familiar with. Frankly hospice was very helpful until death and then things went downhill fast. Their overriding consideration was accounting for and destroying (an hours-long process) every drug. I found that when hospice is involved the funeral home won't touch the body for hours until that last vial of whatever is found. If you're missing any drugs I guess you're stuck with the body for life (yours, not the deceased's.)
My FIL died on hospice last September. We were prepared to give the drugs back. They weren't much interested. So we sold them on the street. (I'm kidding...we used them ourselves)

I think we dropped them off at the local pharmacy.

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Re: death certificates...hospice and 911

Post by RickBoglehead » Tue Jun 12, 2018 8:05 am

Experiences will differ by state, locale, and parties involved. Some hospice groups may be great, others may be terrible.

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cheese_breath
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Re: death certificates...hospice and 911

Post by cheese_breath » Tue Jun 12, 2018 9:25 am

Is the question who prepares the death certificate? Or where can you get it?

https://www.nolo.com/legal-encyclopedia ... icate.html
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Re: death certificates...hospice and 911

Post by vested1 » Wed Jun 13, 2018 9:47 am

coffeehubcap wrote:
Mon Jun 11, 2018 5:09 pm
If you die at home and call 911 who issues the death certificate? If you're in hospice who issues the death certificate.
If you die at home I doubt that you will calling anyone, sorry, couldn't resist.

We just initiated hospice for my 95 year old MIL at the doctor's suggestion. As others have said, hospice doesn't supply a death certificate, it is filled out by a doctor or medical professional and certified by the county. Multiple (at least 5 in my experience) copies should be obtained. You can't believe how many agencies want to have their own copy.

We went through this with my mom and dad, who were both in their 90's when they died at home under hospice care. If cremation is desired it's best to arrange and pay for that service beforehand. We used the Neptune Society for my parents. They came and picked up the bodies of my parents immediately and handled all the details during a difficult time.

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dm200
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Re: death certificates...hospice and 911

Post by dm200 » Wed Jun 13, 2018 10:07 am

In some areas, when there was a death at home - the Coroner would be called. In my home community - at one time this was a Physician - although now it is not.

coffeehubcap
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Re: death certificates...hospice and 911

Post by coffeehubcap » Wed Jun 13, 2018 10:44 am

Bad choice of words on my part. I won't be calling 911 if I die at home. Thanks for all who shared.

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Re: death certificates...hospice and 911

Post by spectec » Wed Jun 13, 2018 10:58 am

Much of the answer depends upon local law and whether your local follows the ancient Coroner system or the more modern Medical Examiner system.
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Re: death certificates...hospice and 911

Post by cheese_breath » Wed Jun 13, 2018 11:48 am

coffeehubcap wrote:
Wed Jun 13, 2018 10:44 am
Bad choice of words on my part. I won't be calling 911 if I die at home. Thanks for all who shared.
But you might be if you die somewhere else??????
The surest way to know the future is when it becomes the past.

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dm200
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Re: death certificates...hospice and 911

Post by dm200 » Wed Jun 13, 2018 11:50 am

spectec wrote:
Wed Jun 13, 2018 10:58 am
Much of the answer depends upon local law and whether your local follows the ancient Coroner system or the more modern Medical Examiner system.
Since I moved away from this rural area a long time ago, I don't follow all details. However, a few years ago, the County Coroner was not a physician - but rather an undertaker (or mortician) employed by a local funeral home. Sure seemed like a "conflict of interest" - but I no longer live there - but have a lot of relatives still there.

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Re: death certificates...hospice and 911

Post by spectec » Fri Jun 15, 2018 11:22 am

dm200 wrote:
Wed Jun 13, 2018 11:50 am
spectec wrote:
Wed Jun 13, 2018 10:58 am
Much of the answer depends upon local law and whether your local follows the ancient Coroner system or the more modern Medical Examiner system.
Since I moved away from this rural area a long time ago, I don't follow all details. However, a few years ago, the County Coroner was not a physician - but rather an undertaker (or mortician) employed by a local funeral home. Sure seemed like a "conflict of interest" - but I no longer live there - but have a lot of relatives still there.
True. It's a bit like being a parking meter reader who also owns a towing service.
Don't gamble; take all your savings and buy some good stock and hold it till it goes up, then sell it. If it don't go up, don't buy it. - Will Rogers

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dm200
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Re: death certificates...hospice and 911

Post by dm200 » Fri Jun 15, 2018 11:40 am

spectec wrote:
Fri Jun 15, 2018 11:22 am
dm200 wrote:
Wed Jun 13, 2018 11:50 am
spectec wrote:
Wed Jun 13, 2018 10:58 am
Much of the answer depends upon local law and whether your local follows the ancient Coroner system or the more modern Medical Examiner system.
Since I moved away from this rural area a long time ago, I don't follow all details. However, a few years ago, the County Coroner was not a physician - but rather an undertaker (or mortician) employed by a local funeral home. Sure seemed like a "conflict of interest" - but I no longer live there - but have a lot of relatives still there.
True. It's a bit like being a parking meter reader who also owns a towing service.
I just looked it up on the internet. They now have several coroners in this rural county. One is the above mentioned mortician. Another is a mechanic - and volunteer EMT. Yet another is a registered nurse. They also seem to have access to a Physician when needed or desired.

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Re: death certificates...hospice and 911

Post by Katietsu » Fri Jun 15, 2018 12:31 pm

tibbitts wrote:
Tue Jun 12, 2018 6:51 am
I don't believe hospice had anything to do with the death certificate in the case I'm familiar with. Frankly hospice was very helpful until death and then things went downhill fast. Their overriding consideration was accounting for and destroying (an hours-long process) every drug. I found that when hospice is involved the funeral home won't touch the body for hours until that last vial of whatever is found. If you're missing any drugs I guess you're stuck with the body for life (yours, not the deceased's.)
I don’t think this is the norm. I am very sorry for your experience.

Katietsu
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Re: death certificates...hospice and 911

Post by Katietsu » Fri Jun 15, 2018 12:47 pm

dm200 wrote:
Fri Jun 15, 2018 11:40 am
spectec wrote:
Fri Jun 15, 2018 11:22 am
dm200 wrote:
Wed Jun 13, 2018 11:50 am
spectec wrote:
Wed Jun 13, 2018 10:58 am
Much of the answer depends upon local law and whether your local follows the ancient Coroner system or the more modern Medical Examiner system.
Since I moved away from this rural area a long time ago, I don't follow all details. However, a few years ago, the County Coroner was not a physician - but rather an undertaker (or mortician) employed by a local funeral home. Sure seemed like a "conflict of interest" - but I no longer live there - but have a lot of relatives still there.
True. It's a bit like being a parking meter reader who also owns a towing service.
I just looked it up on the internet. They now have several coroners in this rural county. One is the above mentioned mortician. Another is a mechanic - and volunteer EMT. Yet another is a registered nurse. They also seem to have access to a Physician when needed or desired.
Where much of my family lives, coroner is an elected position. Anyone can run. The person who wins the election must then take a state approved training class which lasts for only one week. The most common background is a funeral director but there is no specific prequisite at all. If the coroner determines an actual investigation needs to be done, they send the body to a medical examiner’s office in the closest major city.

Fortunately, I have limited experience in dealing with death where there is a question as to the cause. However, I do think you can more likely get away with murder, literally, in these places. The instances where I have had knowledge of an unexpected death, I have been quite surprised at how readily it was attributed to either an accident or a heart attack with no autopsy.

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