Some questions about Hospice

[mickeymouse1205]

Hi,

I do regular home health per visit. I only have experience if you want to call it that in Hospice with LTC. Thee are probably stupid questions but it is just my curiosity. As A hospice nurse do they require you to have your CPR certification current? Also I know back in LTC we were always told by the hospice nurses, they didn't cover under their services, x-rays, labs, or any meds that were not connected to their diagnosis(that were reasons to be on hospice) Is that true with Home hospice patients also?

[NurseAlwaysNForever]

I think the CPR would be a per facility/company thing. The company I work for does not require it. As far as supplies, etc. Medicare only reimburses the hospice for all palliative treatment/medications and for symptom control for the dx that they were admitted to hospice for.

For example: Esophageal cancer pt with trach and peg tube. Hospice would pay for all pain meds, anti anxiety meds, laxatives/stool softeners. Hospice would supply oxygen, suction machine, hospital bed, (basically all durable medical equipment) trach care supplies, peg tube feedings/peg supples d/t pt not being able to eat because of the trach for the esophageal cancer.

Pt Cardiac: Hospice would supply all cardiac meds, diuretics and KCL, pain meds, anxiety meds, durable medical equipment. However if they had a peg tube those supplies would not be covered.

Pt on hospice for cancer and mass is large which is causing a lot of pain d/t it's size and oncologist feels that chemo or radiation would shrink the mass enough to decrease pain, with the realization that it would never be curative, hospice would be responsible. It would be considered palliative treatment.

As a courtesy to our pts we draw all of their labs to save them from making an unnecessary trip to the MD office. We don't get paid for that, it is just something we do. Labs should be covered in some instances because the hospice has to have certain labs for recertification, but I don't know if they are or not.

The list of different things covered is endless. Also if a pt is on hospice for COPD and gets admitted to the hospital for COPD the pt has several different options. First to decide if they want palliative or aggressive treatment. If they want palliative treatment and the facility has a contract with the hospice they can be admitted as inpatient hospice and receive their palliative treatment in the hospital. If their is no contract and they want palliative or aggressive treatment they have the option of revoking their hospice services so that they are not responsible for the bill. Also if they are admitted for their diagnosis and do want aggressive treatment they have the option of signing a revocation so that they aren't billed.

There is a lot more to all of this. Was just trying to cover the basics. Hope it helps some.