Advances in medicine are allowing Americans to live longer than ever, but The Best Care Possible argues that we are doi...Read more
End-of-Life Dilemma: Hospice or Nursing Home?
- February 27th, 2013
End-of-life care decisions are never easy, but many Medicare recipients are being forced to choose between nursing home or hospice care, although neither by themselves may be ideal for a patient nearing the end of life.
Nursing homes are great for providing around-the-clock care, but in general hospice care is considered to be better at treating end-of-life pain and suffering and for providing support for the patient and the patient's family.
Local Elder Law Attorneys in Ashburn, VA
Margaret A. O'Reilly, PC
Margaret A. O’Reilly is an estate planning and elder law attorney with over thirty-five years of legal experience. Attorney O’Reilly graduated from Duke University with a degree in psychology, and received her law degree from Northeastern University School of Law in Boston, Massachusetts. For over 15 y...
The Estate Planning & Elder Law Firm PC
Bill founded The Estate Planning & Elder Law Firm, P.C. in 1994. Bill limits his practice to the areas of estate planning and administration, incapacity planning, Medicaid, asset protection planning, and elder law. He is one of (15) fifteen attorneys practicing in Virginia, Maryland and the District of Columbia, ce...
Felinton Elder Law & Estate Planning Centers
Mindy Felinton concentrates in the areas of Medicaid planning, Veterans' Benefits, asset protection, nursing home planning, elder law, wills, estate planning, trusts, living wills, powers of attorney, probate administration and trust administration and began her legal career 30 years ago as an Assistant State Attorney...
But although Medicare provides a limited nursing home benefit as well as hospice coverage, it usually doesn't reimburse for both benefits at the same time, putting recipients in a tough position.
Medicare covers up to 100 days of "skilled nursing care" per illness following a hospitalization. This coverage includes the cost (plus a co-payment after 20 days) of a semi-private room, meals, skilled nursing and rehabilitative services, and medically necessary supplies. Meanwhile, Medicare's hospice benefit covers doctor and nursing services, medical supplies, drugs, home health aide services, counseling and spiritual care, among other things, but it does not cover room and board.
Medicare won't pay for both benefits at the same time unless the patient is receiving the care for separate illnesses. This means that although a patient can receive hospice benefits in a nursing home, the patient would have to pay out of pocket for room and board if he or she chose to do so. In addition, patients must forgo aggressive treatment in order to receive hospice benefits, which may be scary. Not surprisingly a recent study found that about one-third of Medicare recipients used the skilled nursing benefit at the end of life rather than the hospice benefit.
But officials are aware of the problem and things may be changing. As part of the Affordable Care Act the government is required to conduct a three-year study of providing concurrent care for Medicare patients. Participants at 15 hospice sites will be allowed both hospice and nursing home benefits at the same time.
For a New York Times blog post on the choice between hospice and nursing home care, click here.
Last Modified: 02/27/2013