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?
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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.
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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.
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.
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.
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.