Hospice patients domiciled in LTC Facility questions

[BackfromRetirement]

Would someone please clarify the division of duties between Hospice and LTC personnel? Why would a resident be domiciled in a ltc facility if hospice is in charge? What are the specifics? Medications; are they given by hospice or ltc nurses? How soon is the Hospice admission evaluation placed in the ltc charts?

[FLArn]

Hospice is a philosophy of care and not necessarily an actual physical building. In many areas, the hospice has no inpatient facilities and all care is provided in the patients' homes whether that be a private residence, ALF, SNF or cardboard box under the freeway overpass. Usually when the patient is a resident of a LTC facility, the SNF/ECF retains primary care of the person so they continue to bill for room/board etc. The SNF nurses continue to give meds etc and the hospice nurse/physician would act as consultants in charge of assessing and ordering pain and symptom management and providing support for the staff and the patients' families. I suppose what hospice "paperwork" is left with the patients' charts would depend on the particular hospice involved. We leave the patient's "home" folder with their chart. The biggest issue is getting the staff to remember to call the hospice team for uncontrolled symptoms and decline rather than 911. Hope this helps to answer your questions.