May 30 2018
Written By
Barbara Karnes
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A Hospice With Integrity

A Hospice With Integrity


Cheryl - June 30 2018

I used to be a hospice nurse, I went out to do a readmission on a patient, she had come off service as she had improved. I walked in, she came walking out of her room, went to the kitchen got a glass out of the cabinet then used the ice/water in door Refridgerator, this was a dementia patient, i asked family what had changed since discharge, they told me nothing. I did not admit, the hospice I worked for agreed

Methoda - June 10 2018

Great comments. Very helpful.

Barbara - June 07 2018

Hi Shannon, thank you so much for the info on charging protocol. You’ve taught me something. Blessings! Barbara

Shannon - June 05 2018

I can think of a couple of situations in which a hospice could bill a patient directly. If the individual has a co-pay or deductible with their private insurance. Another situation could be if the hospice is out of network.
A hospice has 3 days to inform an individual if they are out of network or if there is a deductible and what the charges would be. If an individual chooses to stay on after those 3 days, then they would be responsible for the charges. If an individual comes off hospice before those 3 days, then hospices usually don’t charge for those 3 days.

Nancy Buckingham - June 03 2018

My husband came home from the hospital and then rehab facility and in two weeks our home health suggested hospice. He was on hospice for 11 1/2 months. My brother was living with us and he helped me take care of my husband daily and nightly. I could not have done it without him. I quit work and so glad I did so I could spend all my time with him. We had been together for almost 30 years, he transitioned to Heaven May 14th, just 3 weeks ago. I miss him terribly, I am lost, I really did love taking care of him. We fell in love all over again and our love went to a level I did not know existed. It was a beautiful year, difficult, but beautiful. Thank you for all your info. Families need more info about hospice. Thank you again

Barbara - June 03 2018

Hi Nancy, in regard to your question about patients and families being charged for hospice services: if the hospice is medicare certified (and most in this country are) then services are paid by medicare and most insurance policies. Services include nursing, bathing, social work, chaplain, physical therapy, occupational therapy and payment of medications that relate to the life threatening illness. These services are determined appropriate by the hospice. The patient is not charged for these services. The only exception I can think of where the patient/family is charged for anything would be if there was a hospice house and the patient stayed under private pay when the inpatient time frame ended. Most hospices, however, do not offer that payment and stay opportunity. Nursing facilities often offer hospice services. There should be no charge for hospice but there would be the continued room and facility care charges. I am wondering if that is what has happened here because it does not make sense that there are direct charges to the patient and family from just a hospice. Thank you for reaching out to me. Blessings! Barbara

Patrice Kreitler - June 03 2018

Thank you Barbara for writing about this very interesting topic. As most hospice professionals I have seen this for years. We have discharged a patient for extend prognosis and 5 minutes later is on another hospice. Part of the problem is hospices are hiring physicians that don’t know the hospice regulations or criteria for admission. Plus certain referral sources want the service and threaten to transfer their patients. I have a list of things I have seen all too often. Your advice is spot on. Hire quality staff, train them well, provide excellent care and lastly hold your head high in the community. It took me awhile but I have that respect at running a hospice that will always do it the right way.

Nancy Mattson - June 03 2018

I’ve not checked and don’t know how to. Folks were charged for hospice. Is this true? Doesn’t the individual’s heath insurance cover the expenses? Can the services be duplicated particularly medicines by doctor and hospice?

A patient was just accepted into hospice but died before he received the services somehow his savings was depleted. Could be they are blaming hospice since I can’t check out the story but a number of years ago, a patient complained that they got a huge bill from hospice. Thanks for taking my question. nancy mattson

Gary Yepsen - May 31 2018

Thank you for your input Barbara. As a hospice chaplain you insight is always welcome.

Take care,

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