The “Things” Part of Hospice

MEDICATIONS

Hospice provides medications that address symptoms related to the terminal diagnosis. All medications are prescribed by the attending physician and delivered by a courier service to the patient’s home. Medications are available to the patient 24 hours a day. The hospice nurse is responsible for ordering medications and will arrange for delivery at a time convenient to the patient/family. Let the office know if the patient is running low on any medication. 

MEDICAL EQUIPMENT

Medical supplies, walkers, wheelchairs, hospital beds, oxygen and other medical equipment that would be of service can be delivered to the patient’s home. Gateway Hospice orders this equipment, which is delivered by our supplier. Equipment that is no longer needed will be retrieved by the equipment company at the request of the patient, family, or an IDG member. 

Where does Hospice Care Happen?

Hospice is a type of care, not a place. Hospice can happen wherever a patient calls home. This could be in a Skilled Nursing Home (SNF), an Assisted Living Facility (ALF), Independent Living Facility (IL), their home – such as a house or an apartment, even a hotel or homeless shelter. 

Hospice Care in a skilled nursing facility is quite similar to home hospice care. Hospice manages all care related to the patient’s terminal diagnosis. In many cases, the staff of the nursing facility acts as the primary caregiver (a role that must be filled by family, friends, or in-home staff when hospice is given at home — see our section on The Caregiver’s Role). Gateway Hospice collaborates with each facility in which our patients reside to develop a coordinated Plan of Care, which ensures that all caretakers are working together to meet the patient and family’s needs, wishes, and goals.

It is important that the entire team, staff, and volunteers communicate effectively with facility staff when visiting a patient. 

THE MEDICARE / MEDICAID HOSPICE BENEFIT

The following levels of care are available under this benefit. 

Routine Home Care

This is the most frequently used level of care. Under a Routine Level of Care, the Hospice Team is available on a scheduled basis and is available for consultation or to make a visit 24 hours a day. Visit frequency is determined by the IDG in response to the patient’s needs and is documented in the Plan of Care.

General Inpatient Care

Short-term inpatient care may be used during times when a patient and/or family has an immediate and apparent need. This level of care is most often needed for pain control or acute symptom management and can only be provided in a Skilled Nursing Facility or hospital that is contracted with Gateway Hospice. Once symptoms are well-managed, the patient will be returned to the routine level of care, in the current setting, or at home. 

How do patients pay for Hospice?

Most of Gateway Hospice’s patients utilize a Medicare or Medicaid benefit. This usually covers 100% of the cost of Hospice. Some patients use private or commercial insurance. These patients often have a co-pay. Because we receive money from the federal government for Hospice services we have to follow their guidelines. Hospice is required to pay for the “people” and the “stuff” as shown above for our patients when it is related to the terminal diagnosis or to comfort. We are also responsible for moving patients to different levels of care if their symptoms require it. 

Inpatient Respite Care

Inpatient respite care is available to home patients in order to give the caregiver relief and is limited to five consecutive days. This level of care is provided in a skilled nursing facility. 

Continuous Home Care

Continuous care is provided when symptoms need acute management in order to prevent hospitalization. Under the continuous care benefit, a minimum period of eight hours of care is provided during a 24-hour day. Nursing care by either a Registered Nurse (RN) or Licensed Practical Nurse (LPN) must be provided for more than half of this period of care.