Is anyone else finding it hard to support in-patient level of care for your hospice patients? We are trying to follow NGS / medicare guidelines and try all interventions in the home first as well as trying not to transfer patients to in-patient unit (GIP) if actively dying and the patient happens to be 'comfortable'. This is particularly difficult as we also ask end of life preference (home/facility) and many pts / caregivers want to transfer to facility 'when the time comes' however NGS does not consider 'actively dying' a valid reason to bill GIP level of care. Of course if there is caregiver breakdown/stress we try to bring in at respite or routine homecare rate. Has anyone come up with another use for beds on inpatient unit if you are struggling to keep them filled? I work at a hospice with a homecare census around 100, and around 40 nursing home pt census. Our free-standing unit has 10 GIP beds. We also have 10 residential beds which remain 100% full 99% of the time.Thanks for any suggestions / ideas!