The facility has a policy for residents generally that if a resident falls and hits their head, the facility will call 911. It took awhile to work out with the facility that the facility staff should call my sister (closest to our mom) or the hospice staff when my mom fell down. It also took awhile for my sister to understand that being a hospice patient isn't just for getting more care; there is a corresponding expectation that the patient shouldn't go to the ER for everything. My sister also mentioned today that with the new PCP program, our mom wouldn't need to go to her current PCP for the annual Medicare wellness visit. I googled that immediately and tried to gently convey that hospice patients shouldn't be having Medicare wellness visits.
But do make an appointment with the facility this person resides in. Many of them have exactly this policy. If a person falls and there is no apparent broken bones, then no ER visit UNLESS there is an injury to the head. EVEN IN HOSPICE patients, an ER visit may occur with broken bones after a fall; that falls under comfort care. Even in Hospice patients the ER visit may be necessary under the rules of the facility, even the laws of the state, if there is an injury to the head. They cannot afford suits later if a hematoma to the brain or a brain bleed shows that was cause of death, and the family, despite hospice, swoops in the say that it was negligence of the facility that killed, not the disease. Stranger things have happened.
So do get things straight with administration there; there are times, even in hospice, that people have to go to the doctor, odd as all that seems.
There should be a note posted in the room that says something like...DO NOT CALL 911 call XXX-XXXX if there is a change is status.
Has your sister had a meeting with the Hospice Nurse or Social Worker so that they can fully explain what the expectations are? If not that might be a good idea so that she is aware of what can and can not be done. It will sound different if it comes from Hospice and not you (even though you are giving her the same information)
There is the slight possibility that if mom is still being sent to the ER or if she is seen by the doctor from the facility that Hospice might drop her. The reason would be that Medicare can not be billed for duplicate services. (Medicare covers Hospice and they are billing so the facility doctor would not be able to bill for his services. (now if he wants to do it free that is up to him)
The fact that your mom is now under hospice care means that they believe that she will be dying in the next 6 months or so, and any care that is needed for her will be taken care of by hospice.
All hospice agencies have their own doctor, PA and many nurses to handle anything that may arise, so there is NO need for any outside doctors whatsoever.
Perhaps you and your sister should sit down with the hospice agency your mom is with so you both can better understand what their role is with your mom, so this conversation about what PCP is best for your mom can stop as she doesn't need her own PCP at this point, as she has the hospice doctor now.