Hospice in the Nursing Home

Hospice care is a specialized type of care for those with an illness that we would expect to result in death in six months or less. Hospice is not a place, but a philosophy of care. Hospice emphasizes quality of life, pain management, and comfort care. Most individuals receiving hospice care do not receive curative or intensive treatments including chemotherapy or radiation. Hospice care can take place in a home, a hospital, an inpatient hospice facility/unit, or a long-term care facility, such as a nursing home. Many individuals prefer to stay in their homes at the end of their lives. However, hospice care is accessible to those who may need more extensive care and support in a nursing home/long-term care facility. Hospice agencies are able to provide hospice services to residents of nursing homes/long-term care facilities. The hospice and the nursing facility agree upon a coordinated plan of care that reflects the hospice philosophy of enhancing the quality of life through expert pain and symptom management.

Hospice care provides an interdisciplinary team approach to support and enhance end-of-life care provided in the nursing facility. The team works closely with the patient's own physician as well as the facility's care team.  All aspects of care related to the hospice diagnosis are covered by insurance, including:

• Skilled services including nursing and physical therapy if these services are directed towards comfort care and pain management.
• Medications related to the terminal diagnosis.
• Durable medical equipment (hospital bed, commode) and most supplies related to the terminal diagnosis.

However, room and board charged by the nursing home are typically not covered under the nursing home/hospice agreement. Be sure to ask the nursing home and hospice team about potential out-of-pocket expenses associated with room and board at the facility.

Eligibility requirements for residents of a nursing facility are the same as for patients living in their own homes who desire a focus on comfort and palliation of symptoms rather than curative approaches. If eligible, services are covered under Medicare Part A, Medicaid, or private insurance depending on your insurance coverage. Talk with your social worker about options for hospice in a nursing home or other long-term care facility.