Hospice wants husband to sign promising to pay for MIL's care if Medicare won't. Any advice?

Follow
Share

My MIL is currently in a nursing home with Medicaid pending. Someone, I'm not even sure who (we're dealing with so many people -- social workers, caseworkers, hospital people, nursing home people), suggested having her apply for hospice on the grounds that Medicare would then pay hospice bills, and they are more prompt and reliable about payment than Medicaid. My husband was at a meeting about this yesterday, and they wanted him to sign something saying he would pay if Medicare didn't. He refused, so I guess she won't get hospice. Probably doesn't really matter. She is already on palliative care.


It isn't that we aren't willing to help MIL financially. We have been doing that for years. It's just that this sounds like asking us to write a blank check. Medical costs can be very high, and if Medicare refuses to pay after charges have been made, it seems like we could lose everything we have if DH were to sign what they wanted him to.


Does anyone know if this is standard procedure for hospice?

This question has been closed for answers. Ask a New Question.
13

Answers

Show:
This is hindsight but Medicaid usually pays for dental. My nephew gets his paid. Mom saw a dentist in the Home, she paid nothing. Not sure how it goes with as many problems ur Mom has. Medicare does not pay dental.
Helpful Answer (0)
Report

Was this a for profit hospice or not for profit. My experience has only been with a not for profit. Medicare and most private insurance pays for hospice on a daily basis.We often took care of patients in local nursing homes that hospice had a contract with. The major part of the daily reimbursement went to the NH.
If a patient was not old enough for Medicare then they had to private pay but usually a small amount based on income. no one was ever turned away because they could not pay.
Thank goodness your hubby had the sense not to sign anything or he would be writing lots of big checks every month.
Hospice does not accept anyone who does not have a disease that will probably limit their life to six months. As long as they continue to decline their elidgeability has to be assessed every six months but can be continued almost indefinitely.

The admission process is usually conducted by the admitting nurse on the recommendation of the patient's own PCP. The nurse visits the patient, does a physical assessment . Paperwork is signed DNR is discussed and recommended but not compulsory. Family is usually present and someone has to take responsibility as primary caregiver which can be family or a friend. A social worker may be print to take part in the admission and help with the paperwork and any applications for things like Medicaid. Medicaid may be needed for any meds or treatment not related to the admission diagnosis.
The PCP continues to follow the patient and prescribe although Hospice MD can also do this especially out of office hours.
An admission will usually take about two hours.
Helpful Answer (0)
Report

It may have been a health issue. We aren't sure whether she would qualify for hospice. I think maybe heart problems are harder to predict. My mother died about three years ago. She was on hospice, but she had cancer. Her doctor could predict with a high degree of confidence that she had less than six months.

I'm not really too worried about MIL getting hospice. She is in a clean, safe place where she is getting good care and is physically comfortable. Mentally, not so much. She is demanding to go home and just gets madder when DH tries to explain why we think that would be a bad idea.

Thanks again, everybody on the forum. The advice I have gotten here has been a lot of help. I'm really glad I found this site.
Helpful Answer (2)
Report

This is purely a guess. Hospice eligibility is based on health. In this case there was a proposal that it be applied for based on financial considerations. In that case there was no guarantee that MIL would be eligible once hospice had a chance to do their review process. And they wouldn't want to start their care until that was complete -- unless someone promised to pay them if the request wasn't approved.

Could that be it?

Seems like the solution would be to apply for hospice. If it gets approved, start hospice. Nobody should have to sign any financial promises.
Helpful Answer (2)
Report

Well, I don't know what's going on then. She's on Medicaid-pending for the nursing home. The first we were asked to sign anything guaranteeing payment was at this hospice meeting.
Helpful Answer (0)
Report

Dogperson, I found this on the Medicare website about Hospice care: medicare.gov/coverage/hospice-and-respite-care.html

In a nut shell, Hospice does not bill you for the care they give. Note that Hospice does not pay for room and board in a facility, it is up to Mother-in-law to pay, be it self-pay or by way of Medicaid. I have a feeling that is where the mix-up begins.

Both my parents had Hospice. Both were in different facilities at different times. Never got a bill from Hospice. Now, my parents had to pay the facilities the room/board and routine care.
Helpful Answer (5)
Report

I would report this hospice organization to your Attorney General
Helpful Answer (3)
Report

No, this was hospice, and it was Medicare, not Medicaid, they were concerned might refuse to pay. The nursing home has not asked us to guarantee payment. They took her Medicaid-pending, with no requirement for us to sign, and she has been there for several weeks now. It was only when hospice was suggested and there was a meeting to discuss it that anyone wanted DH to sign anything. Meeting broke up real fast when he refused.
Helpful Answer (0)
Report

I'm sure it was not hospice that stipulated the payment arrangement. Hospice is paid by Medicare, not Medicaid, so whether Medicaid was approved or not would not matter to the Hospice program. And once hospice is approved, Medicare pays.

Hospice does not cover room and board, so if Medicaid is turned down, it is the nursing home that will lose out.

I wouldn't waste time investigating other hospice organizations. This is not a hospice rule.

You can't blame the NH for wanting to get paid, no matter what, but you sure don't have to sign up to be the ones that pay them.
Helpful Answer (4)
Report

Thanks, Grammyteacher. We'll look at the possibility of a different hospice organization. These folks are all heart {insert sarcasm icon}.
Helpful Answer (0)
Report

This question has been closed for answers. Ask a New Question.
Related
Questions