How often can you have respite care on hospice?

I have a question? My mom has United Health Care through AARP. How offen can I use respite. I'm here caregiver and daughter?

There is no mandated limit on respite care per Medicare COP's. It should be based on the patient and family need.

http://www.nhpco.org/sites/default/files/public/regulatory/Respite_Tip_sheet.pdf

I have been studying this. Medicare allows up to 20% of hospice days as respite days and each respite period not to exceed 5 days. For example 5 days every 25 days maximum. What your Hospice allows is dependent upon how greedy they are and what they agree to in your contract with them. You have to pay the Medicare 5% of their standard rate for inpatient care at a Medicare approved inpatient facility (haven't found out yet what that dollar figure is).

I want to correct my earlier post. One respite period per certification is my employer's policy, not MediCare's. The reason for hospice agencies promising different amounts of respite is linked to reimbursement rates and other factors. Respite care pays less than in home care and there is concern about audits if the benefit is used often with the same patient. Here is the correct answer from the NHPCO Tip Sheet for hospice providers:
HOW OFTEN CAN A CAREGIVER ASK FOR RESPITE CARE?
• More than one respite period (of no more than 5 days each) is allowable in a single billing period.
• If the beneficiary dies under inpatient respite care, the day of death is paid at the inpatient respite
care rate.
• Frequent use of respite care for one patient or unusual patterns of respite care may be a red flag to
your Medicare Administrative Contractor (MAC). Documentation must justify the reason for the
caregiver relief. (ie: 5 days of respite with a one day break and another 5 days of respite)

Amazing how every state is different. Hospice told us we get up to five days respite care and we could take my mom home anytime during that give days. Dad bought her home on the fourth against my advice.

This is good to know.

live in los angeles...mother just went on hospice, they said i get 5 days a month!!! wow...sounds like heaven but...i haven't seen the places she would stay in. that could be a nix on this idea! they also said that patient must stay the whole five days...or i would lose this opportunity!

The director of the hospice facility that you are using can give you the most accurate answer as it relates to that facility and their ability to assist in finding you volunteers to assist with respite care. Good luck!

The answer is: up to five days for every certification period. Certification starts with 90 days, followed by another 90 days, and then moves to 60 day increments. The hospice will arrange for a bed at one of their contract facilities which may be with a free standing hospice operating specifically for general inpatient and respite levels of care, or a skilled nursing facility. This needs to be arranged ahead of time so speak with your hospice RN or social worker, or chaplain who can call the Team Leader to begin the process.

Since you live where you live, our suggestions will be useless. Talk with all the hospice providers in your area, and they will determine how much respite you get. You can always pay for services out-of-pocket. I'm exhausted too!

My mother was just in respite care. We were told by Hospice that she could go in the nursing home every 60 days for five days. We live in the state of Ohio so I don't know if that could make a difference. Hospice should be able to answer your question.

chantein, what caring people you guys are! I don't have any experience to share, but Yes, I'd make more phonecalls like guest suggests. Maybe there's another level of support you have to sign up for. Best wishes.

It depends on what insurance the hospice benefits are from - some seniors opt for Medicare Advantage plans and those may be different from "traditional Medicare". Contact the hospice organization that is providing the care and they will tell you exactly what respite benefits are covered - how many days and how often. Don't just take the word of people who may not know what the insurance plan that your father in law has.