How do you explain Respite vs GIP ???

[AtlantaRN, RN]

I explain GIP as a high level of care preventing a patient from going to the emergency room (uncontrollable anything-bleeding, vomiting, diarrhea)......respite as a "caregiver break....".

Families don't like the "only 5 day" thing so alot don't understand "why can't they go live at the inpatient facility for the next 6 months"---their insurance will pay for it........

what is a tactful way to say that an inpatient facility isn't a nursing home? I'm tired and have worked a week and a half straight..............

thank yo for your help.

[westieluv]

Respite is when the patient is admitted to the inpatient facility because the family or other caregiver needs a break. GIP is when a patient has to be admitted to the facility because one or more of their symptoms cannot be managed at home, and isn't about giving the caregiver a break so much as getting the patient relief from the uncontrolled symptom. At least that is how it works where I am. And here, the family can have the patient admitted for an extended period as long as there is a bed available and their hospice diagnosis remains unchanged.

[volsfan]

There is also a difference in how Medicare pays. They will pay significantly more for someone to be on Inpatient care.

[tewdles, RN]

The bottom line...

there are levels of care in hospice which are defined not only according to how much care they require, but also upon how much payment the hospice receives.

routine care is the most common level of care and can occur in a person's private home, in a skilled facility...basically wherever the person "lives". Most insurance hospice benefits do NOT cover room and board at a nursing facility for this level of care, including Medicare.

respite care is just that...respite - relief - pause - rest. it is temporary and can recur at unclear intervals. respite is paid at a different rate than routine care. respite care does not have to occur in a hospice facility, rather it must be a place that can provide 24hr care and supervision.

general in-patient (GIP) is the highest paid level of care and has very specific requirements for documentation, discipline visits, etc. the insurance carrier generally examine GIP claims closely so it is wise not to be tempted.

the remaining level of care is "continuous care"...the 24hr in home hospice presence in an acute crisis and/or in the last 24hrs or so of life...almost like bringing the GIP to the patient, but not quite. this is a difficult to schedule and maintain program and is frequently a minimally functional attribute of small hospices. continuous care is reimbursed less than GIP but more than routine.

...and finally, too often families want and need support that they cannot afford and hospices cannot afford to provide without reimbursement.