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Hospice is a 100% paid Medicare benefit. So it's self-directed & mom can select the vendor. Usually the NH will have a smallish group of vendors already coming into the NH. NH will suggest 1 of them. If they don't seem to mesh well for mom or you, then mom or you as dopa can switch providers. For my mom, Medicare paid the hospice an average of $ 4,500 a mo. CMS - if mom gets statements- will mail a monthly tally of hospice payment paid.
There was never any problem between Hospicd & the NH staff. At the end it was the NH staff that administered the hospice ordered meds.
For my mom & her family (my brother & I) they were a Godsend. My mom had Medicaid/ Medicare at that point. We never received a bill from Hospice.
Good luck to you!
Very simply put, the patient is still given basic care by nursing home staff but hospice has a care management team. This is a doc, nurse, social worker, bath aid and volunteers for companionship visits, spiritual counseling and grief counseling.
There are variations of this structure depending on the organization but it's usually similar.
Hospice isn't there around the clock, only certain times during the week to check on the patient.... sometimes volunteers will come in to talk or just hold the hand of the patient... a Chaplain or Priest will come if requested.... and there are Aides who will come in to bathe the patient [it all depends on what is available through the local Hospice group].
The nurse has full control of the pain meds and any other meds that are given. And Hospice will usually call the "main person" be it you or someone else to give an update. Hospice is good at determining when the final days are becoming closer.
Once my Mom had passed, the doctor on duty was able to give time of death, then the Nurse called Hospice, and in turn Hospice called the funeral home.
My Dad had Hospice care while in Assisted Living/Memory Care.