Home Hospice Policy

Policy Statements

The purpose of this policy is to balance the privacy rights of terminally ill persons and their family members and the legal duties of the Coroner and law enforcement with respect to unattended deaths. This policy provides procedures for the Coroner, law enforcement, funeral homes, and hospice programs responding to in-home deaths of terminally ill persons receiving medical care through a licensed Home Health and Hospice program (HHHP). This policy is limited to the in-home deaths of terminally ill persons receiving medical care through an HHHP who apparently died from such terminal illness while at the home.

This policy does not apply to deaths involving accidental or suspicious circumstances. All accidental deaths, all suspicious deaths, all deaths where the decedent did not die in the home, and all deaths where the decedent was not receiving care through an HHHP require that law enforcement and the Coroner be immediately contacted through RiverCom and authorization obtained for the removal of the decedent from the home.

Procedure

Each HHHP shall, on a weekly basis, supply RiverCom with an updated list of terminally ill persons enrolled in the HHHP receiving in-home medical care in Douglas County. The list shall include the patient's name and date of birth, the address and telephone number of the in-home care, and the name of the patient's primary physician.

Removed from Facility

A decedent enrolled in an HHHP may be removed from the home without prior notice to and approval of the Coroner only if the removing funeral home is provided with written evidence of the decedent's enrollment in the HHHP or if the decedent's enrollment is confirmed through RiverCom. Patient enrollment forms must be dated and signed. The patient enrollment form shall be provided to and maintained by the removing funeral home. If there is no written evidence of enrollment in an HHHP and RiverCom cannot confirm enrollment, then immediately request that RiverCom dispatch law enforcement to the home.

How to Declare Death

If a medical professional was not in attendance at the time of death, the removing funeral home shall declare death using the following criteria:

• Detectable lividity (livor mortis)
• Detectable rigidity (rigor mortis)
• Pupils fixed and dilated, with no pulse, for one full minute

Identification of Deceased person

The removal funeral home shall confirm the identity of the decedent prior to removal. If identification cannot be confirmed, then immediately call 911 to report the death in order to have law enforcement dispatched to the home.

The Coroner shall be immediately contacted by the removing funeral home upon receipt of the body. A completed In-Home Death - Hospice Program Report shall be provided to the Coroner within 48 hours.

Procedure for Law Enforcement

Law enforcement need not respond to an HHHP in-home death where written evidence of enrollment is provided to the removing funeral home or confirmed by RiverCom. Law enforcement must respond to the death if a funeral home attendant, ambulance service personnel, or any other third party reports an accidental death or suspicious circumstances surrounding the death. If an accidental death occurred or suspicious circumstances exist, then immediately call 911 to report the death in order to have law enforcement dispatched to the home.

Procedures for Funeral Home

The following procedures shall be followed by the removing funeral home:

• The body may be embalmed, but may not be aspirated.
• Two gray top tubes of blood shall be drawn and saved, labeled with the decedent's name, date and time collected, and the initial's of the blood drawer. The tubes shall be refrigerated and stored for one week, subject to retrieval by the Coroner.
• If during wash down any suspicious injuries or other conditions are observed, immediately call the Coroner and/or law enforcement.
• After receiving notification of the death, the Coroner shall advise the funeral home whether the body is released for disposition, shall be held for further investigation, or shall be transported to the Central Washington Hospital morgue or another location for an autopsy.
• The funeral home shall provide a copy of the completed, signed Death Certificate to the Coroner.

Contact

Douglas County Prosecuting Attorney/Coroner
P.O. Box 360
Waterville, WA 98858
Phone: 509-745-8535
Fax: 509-745-8670