Linking To And Excerpting From CORE IM’s “Hospice 101: Nuts and Bolts”

Posted on October 29, 2024 by Tom Wade MD

Today, I review, link to, and excerpt from CORE IM‘s Hospice 101: Nuts and Bolts.*

*Posted: July 24, 2024
By: Dr. Shreya P. Trivedi, Dr. Mahathi Komaragiri, Dr. Gillian Sutton, Roger Schrader, MSW, LICSW, Bryanna Tobin, LMT, Dr. Sarah Schwartz, Dr. Jafar Al-Mondhiry and Dr. Harry Han
Graphic: Dr. Jesse Powell
Audio: Daksh Bhatia
Peer Review: Dr. Charlotte Grinberg, Dr. Helen Knight, Dr. Mara Feingold-Link

All that follows is from the above resource.

Play podcast in new window

Time Stamps

  • 03:05 What is hospice care and its philosophy?
  • 06:15 Who qualifies for hospice?
  • 08:19 Who makes up the hospice interdisciplinary team?
  • 17:25 Who pays for hospice?
  • 21:34 What are the different levels of hospice care?
  • 31:59 What are some limitation of the hospice Medicare benefit?

Sponsor:*

*I have no relationship with CORE IM nor with this sponsor. I just included this as a way of thanking the good people at CORE IM.

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Behind the Scenes Interviews

Music Therapy in Hospice Intro

How Hospice Music Therapy Touched A Family

Challenges in Hospice Music Therapy Field

Show Notes

Pearl 1: Philosophy of hospice

  • Hospice is the shift in focus of care from curing the illness to focusing on comfort, pain relief and symptom management.
    • Don’t forget that comfort includes more than physical comfort.

Pearl 2: Who qualifies for hospice?

  •  To qualify for hospice a patient must have a terminal illness.
  • For patients who live longer than that 6 months, a physician or NP will need to re-certify every 2 months
  • The Local Coverage Determination: policy used to determine hospice coverage

Pearl 3: Who makes up the hospice team?

Pearl 4: Who pays for hospice?

  • Most insurance follows the Medicare system in which a patient who is enrolled in hospice will then have a Hospice Benefit that directly covers medical, nursing, counseling, and bereavement services.
    •  Unfortunately, this means that many of our uninsured patients face challenges when enrolling in hospice.
  •  The hospice agency is then paid a fixed daily rate for every patient in hospice based on the level of care. This fixed rate includes medications, DME and personnel.

Pearl 5: What are the different levels of care and what are the limitations of the hospice benefit?

  • There are 4 levels of hospice care
    • Routine level of care
      • Takes place at home (nursing home, assisted living, independent living home, etc) where the hospice team comes to see the patient as needed.
    • General Inpatient Care (GIP)
      • Takes place in the hospital or at a GIP hospice facility for patients who need management of uncontrolled symptoms that cannot be provided at home.
    • Respite care
      • For patients already enrolled on hospice services with an agency
      • Short term care to relieve the beneficiary’s caregiver for up to 5 consecutive days.
      • The patient will go to an inpatient hospice facility, SNF or hospital.
    • Continuous home care
      •  For brief periods of crisis when a patient needs continuous care in the home setting.
  • Patients qualify for different levels of care based on their symptoms, which is challenging as it still requires significant assistance from the patient’s caregivers.

References

 

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