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Last Updated on May 28, 2021 by Frank Davis
The hospice program is designed to provide patients with the same level of care they receive at the hospital, but in the comfort of their own homes, free from intrusive noise and invasive procedures. As part of this goal, it is important not to intrude on the patient’s privacy and let them spend as much time as possible with their family.
In 2018, 98.2% of care was provided at the Routine Home Care Level, according to NHPCO data. This means a majority of the time a hospice company maintains a 24-hour nurse on-call with nurses visiting periodically throughout the week. The patient can therefore spend as much time as possible with their family when they are at home.
We will go into more detail in this article concerning what 24 hour on call really means, and when Medicare will be covering 24 hour care as an insured benefit.
Hospices are 24 Hour On Call
As the statement “on call 24 hours a day” is likely to cause confusion let me try to make things clear by explaining what we mean by that. It is not intended to mean that a nurse will be at the bedside of the patient 24 hours a day. On call by definition means that the hospice staff is available when the client contacts them. In other words, a nurse is available 24 hours a day only as needed.
Should the patient’s condition change or should an emergency arise, please contact us and we will be able to assist you through the process. When the situation cannot be resolved over the phone, a hospice agency representative will send a nurse to your house to help with the situation. This is done to ensure that costs are minimized and to have a nurse available to assist several families as needed.
In the case of a 24/7 nurse, the cost of maintaining the care would be too much for a hospice agency to be able to sustain. It is important to know that Medicare has specific rules in regards to what they can reimburse. Medicare does cover at least one kind of 24 hour care, but it is subject to certain restrictions. It is covered for a maximum of 5 days and only available in the event of a crisis.
The caregiver, which usually is a family member or a close friend, is the one who does the majority of the non medical home care for the patient. The primary caregiver tends to spend most of the time with the patient, and may assist with bathing and dressing, preparing meals, and administering medications. For those families who are unable to get a relative to help, they have the option of hiring a caregiver through a home care agency. Hospice care tends to the medical needs of the patients, such as medications, pain management, symptom management, medical equipment, and medical supplies, while the caregiver tends to the non-medical needs of the patient
Coverage of 24 hour care by Medicare
Medicare covers 24 hour care only in the event of a crisis, meaning that it is not covered under normal circumstances. A crisis is defined as having uncontrollable pain and symptoms. In cases where acute pain and symptoms are uncontrollable, level 2 continuous home care and level 3 short-term inpatient care are appropriate to manage the crisis. At level 2, a nurse is sent for a minimum of 8 hours and a maximum of 24 hours to assist with controlling the symptoms and pain. If the patient’s crisis persists at level 2, then he or she will be admitted to level 3 Short Term Inpatient Care. There are nurses available 24 hours a day, around the clock to be able to assist the patient during the time of crisis. As it is a short-term stay, typically lasting no more than five days, when the patient begins to improve they are sent back home.
What are my options if I do want 24 hour care
- There are many non-medical home care agencies from which you can hire a caregiver. Prices are determined by who you contact and can change depending on what you are looking for.
- As we have contracts with a lot of facilities in the area, we are able to assist you with finding the right one depending on your financial situation and the location of the facility. There is a nursing staff on site 24 hours a day, seven days a week. It is normally the case that the rates go between $2,500 and $5,000 a month. Medicaid may provide assistance with room and board.
- Family members usually provide assistance with the care of a relative in order to reduce the overall cost of the inpatient care or caregiving.
It is understandable that there can be some confusion when it comes to hospice agencies saying they are available 24 hours a day. It is not intended to mean providing you 24 hour care at your bedside, but rather provided in a way that is more flexible. This is a service that is designed to provide you with 24 hour care upon request at any time. If there was an event such as a change in the patient’s condition or an emergency, you would be able to get in touch with them over the phone. In the event that the situation cannot be resolved over the phone, a nurse is dispatched to the patient’s home to provide assistance.
This was a little bit complicated to explain, so I hope I have done a great job explaining things in a clear manner. If you have any questions feel free to contact us at (818)433-0068. We will be more than happy to help you!
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