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hi Im Dr Vaughan hi Im Dr chartalia today we want to bring up the topic of being admitted to a hospice directly from the hospital weve had some questions about how does that work and so we want to discuss that a little bit with you today so that you can see it can be smooth and it can be seamless for you to go directly from a hospital to a hospice organization and and make it really easy for the patient for the family yeah and theres two ways normally how it does happen patients can be admitted to the hospital that are already on hospice services so basically what happens with those patients is they may have an injury or a traumatic event that occurred that requires hospitalization so they were in the hospital and now theyre going to come back on hospice or in other ways theyre directly emitted from the hospital to a hospice setting so lets break that down a little bit lets talk about the patient thats been on hospice and had an acute exacerbation that was too frightening for