Hi Charlott, I am guessing the PT in your subject line means Patient, not Physical Therapy. In this forum, when someone uses PT, they usually mean the latter.
You asked a good question. I'm interested to know tthe answers too.
Hi Charlotte I think your question is one of those where the answer might be….it just depends.
My DH Aunt was on home health for many years under the homebound provision of original Medicare. When she reached a certain stage in her dementia and loss of ADLs, she transferred to their hospice group. Not much changed except now she receives more services and supplies and a daily CNA assistance with bathing instead of twice a week. She still gets wound care when she needs it-from her hospice nurse. Was not taken off any of her meds and in fact, hospice now covers all meds that relate to the reason she is on hospice (dementia). She still pays for her BP meds, thyroid tablet etc through her drug insurance plan but Medicare hospice pays for the other drugs. In aunts case, there are HH nurses who are separate from hospice nurses so they are in two separate groups. This may be the way aunt’s particular company runs their business but my impression is that it’s a requirement of Medicare as they compensate the company differently for hospice care than they do HH care. I see this on the explanation of benefits I receive quarterly for aunts care. If you go on the Medicare.gov website you can search for hospice providers for your area. Then also search for HH. You will see the ones who offer both HH and hospice. Not all of them do. On this forum you will find responders from a variety of states and countries. We have had similar yet different experiences. You will need to speak with a specific provider in your area to see what their policies are. One of the confusing things for me was to realize that while Medicare may provide for multiple services for HH and/or hospice, not all providers actually offer all of the services medicare says they will cover. My hospice provides aunt with daily baths. Not all hospice in my area offers that. Another hospice might offer music therapy. Aunts does not. While the companies are primarily operating on government funds, they are private and can run the business as they see fit so long as they are in compliance. If you as a HH RN are being asked to provide wound care to a hospice patient, yet you aren’t an “official” hospice RN, your company may be looking at you as a shared resource? With aunt’s particular HH/Hospice company, the CNAs work for both groups but not the RNs/LVNs. I don’t know if that is the case just with my aunt’s company or if that is a Medicare requirement. Aunt has a physical therapist that is compensated by the hospice company. Many will tell you that isn’t provided by hospice. I was able to negotiate that for aunt because I knew the therapist and he knew the owner and they agreed to provide it. Medicare covers it but only through a lump sum daily payment that the provider gets to decide how to spend. Another thing to keep in mind besides geographic area and the companies policies is to also realize that rules change from year to year and what might have been acceptable practice for Medicare awhile back may no longer be the case. Someone wrote in recently looking for a hospice. When I googled their area, there was only one. I suspect in remote areas the rules may be quiet different from where there are multiple choices of providers. Health care is scarce in some areas.
I hope I didn’t entirely miss the point of your question. Welcome to the forum.
Hospice is for the dying. The person or family want to let nature take its course. So certain meds are stopped and anything that would prolong life. Since Hospice provides an aide, that is not needed by HH. Woundcare is done to help elevate any pain or discomfort. PT is really not needed but maybe used if joints are seizing up and causing pain.
Where I live Home Health and Hospice are the same agency. Medicare pays for both HH and Hospice so the criteria is set by Medicare for what they will pay for. Private insurances differ but they too establish what they will cover and not cover.
You asked a good question. I'm interested to know tthe answers too.
I think your question is one of those where the answer might be….it just depends.
My DH Aunt was on home health for many years under the homebound provision of original Medicare. When she reached a certain stage in her dementia and loss of ADLs, she transferred to their hospice group. Not much changed except now she receives more services and supplies and a daily CNA assistance with bathing instead of twice a week. She still gets wound care when she needs it-from her hospice nurse. Was not taken off any of her meds and in fact, hospice now covers all meds that relate to the reason she is on hospice (dementia). She still pays for her BP meds, thyroid tablet etc through her drug insurance plan but Medicare hospice pays for the other drugs.
In aunts case, there are HH nurses who are separate from hospice nurses so they are in two separate groups. This may be the way aunt’s particular company runs their business but my impression is that it’s a requirement of Medicare as they compensate the company differently for hospice care than they do HH care. I see this on the explanation of benefits I receive quarterly for aunts care.
If you go on the Medicare.gov website you can search for hospice providers for your area. Then also search for HH. You will see the ones who offer both HH and hospice. Not all of them do. On this forum you will find responders from a variety of states and countries. We have had similar yet different experiences. You will need to speak with a specific provider in your area to see what their policies are.
One of the confusing things for me was to realize that while Medicare may provide for multiple services for HH and/or hospice, not all providers actually offer all of the services medicare says they will cover. My hospice provides aunt with daily baths. Not all hospice in my area offers that. Another hospice might offer music therapy. Aunts does not. While the companies are primarily operating on government funds, they are private and can run the business as they see fit so long as they are in compliance.
If you as a HH RN are being asked to provide wound care to a hospice patient, yet you aren’t an “official” hospice RN, your company may be looking at you as a shared resource? With aunt’s particular HH/Hospice company, the CNAs work for both groups but not the RNs/LVNs. I don’t know if that is the case just with my aunt’s company or if that is a Medicare requirement. Aunt has a physical therapist that is compensated by the hospice company. Many will tell you that isn’t provided by hospice. I was able to negotiate that for aunt because I knew the therapist and he knew the owner and they agreed to provide it. Medicare covers it but only through a lump sum daily payment that the provider gets to decide how to spend.
Another thing to keep in mind besides geographic area and the companies policies is to also realize that rules change from year to year and what might have been acceptable practice for Medicare awhile back may no longer be the case.
Someone wrote in recently looking for a hospice. When I googled their area, there was only one. I suspect in remote areas the rules may be quiet different from where there are multiple choices of providers. Health care is scarce in some areas.
I hope I didn’t entirely miss the point of your question. Welcome to the forum.
Where I live Home Health and Hospice are the same agency. Medicare pays for both HH and Hospice so the criteria is set by Medicare for what they will pay for. Private insurances differ but they too establish what they will cover and not cover.