Election of hospice care occurs on the effective date included in a client's hospice election statement. A hospice election statement must include:

• identification of the hospice that will provide care to the client;
• the client's or the client's legal representative's acknowledgement that he or she has been given a full understanding of the palliative rather than curative nature of hospice care, as it relates to the client's terminal illness;
• acknowledgement by Medicare beneficiaries that certain Medicare services, as described in 42 CFR §418.24(d), are waived by the election;
• the effective date of the election of hospice care, which may be later but not earlier than the date of the client's or the client's legal representative's signature and may be the first day of hospice care or a later date; and
• the signature of the client or legal representative.

Source: 26 TAC §558.801(g)