You can do it but you gotta be organized. Hospice is a Medicare benefit so it is considered to be “self directed”, which basically means you (or the dpoa, mpoa) as the Medicare enrollees can pick the provider as long as they participate in hospice and cover the territory where you mom is and they can do the level of care needed.
I did it for my mom within the first 60 day period for hospice. She was in a NH on Medicaid, fell shattered a hip became bedfast and went onto hospice & staying at the NH. My issue with first hospice was primarily abt communication issues as I live in another state and wasn’t getting updates or emails as to her situation even tho I had be assured would happen via email once a week from RN and the 3 times a week aid; AND they were somewhat not taking the long view that she wasn’t gonna die right away. She looked bad when I got there the day after she fell but couple of days in she was asking about getting a sandwich instead of a hot meal for lunch. Death was not anywhere near her. She was one tough old bird in her 90s, really once she got pain meds manageable she was totally bedfast but lively. I spoke with the SW on the downlow as to which other hospice co that already serviced this NH might be better fit, she gave me 2 options. Met RN with 1 & she listened to my concerns & we together went to visit mom bedside & then we together went to nurses station to chat with them. This latter done to make sure the new hospice could deal with mom’s health care needs. All ok. I gave old group a written notice to cancel and did paperwork the new one had me fill out. I had not done paperwork for first hospice as medical director of the NH ordered it and all set in place with biggest hospice group that worked this NH. The paperwork was about 7 pages and you need a dpoa / mpoa unless your elder is cognitive enough to sign. Hospice #2 up & running within 3 days. Hospice paid by Medicare abt $4200-4500 a mo.
This part is important: whatever equipment the old hospice has gotten for your mom will need to totally removed & be picked up. So you have to make sure new group brings in their new equipment ordered ahead of old stuff out. The new hospice group kinda has to have stuff at the ready to load up and haul over. Not all hospice are big enough to do this or have standing orders with equipment vendors to get delivery ASAP. New group had a much quieter pressurized mattress & frame brought in, ordered Geri chair and a Geri bathing chair (first hospice did not order these), nutritionals (twin cal RTF), disposable feeding bibs and met with dietary about switching to mechanized food menu choices rather than just puréed. Plus they could Skype me when the RN or Chaplin visited her & did!. Eons difference approach. Mom was on hospice a l...o...n...g 18 months & was never cleaner & bathed as she was once with this hospice group; they worked really well with the existing NH staff. Just awesome care. I did time the switch so that it was right before my mom’s next standard 90 day care plan meeting & the new hospice RN went to the care plan meeting with me. The new group saw a relatively smaller # of hospice patients at this NH & on retrospect that was much better.
If your doing in home hospice, I’ve heard that some groups will redline neighborhoods. And if your mom is on serious back box warning drugs, like on fentanyl, not all hospice will take that type of patient in an in home setting. Yeah totally can be done but with planning. Good luck!
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I did it for my mom within the first 60 day period for hospice. She was in a NH on Medicaid, fell shattered a hip became bedfast and went onto hospice & staying at the NH. My issue with first hospice was primarily abt communication issues as I live in another state and wasn’t getting updates or emails as to her situation even tho I had be assured would happen via email once a week from RN and the 3 times a week aid; AND they were somewhat not taking the long view that she wasn’t gonna die right away. She looked bad when I got there the day after she fell but couple of days in she was asking about getting a sandwich instead of a hot meal for lunch. Death was not anywhere near her. She was one tough old bird in her 90s, really once she got pain meds manageable she was totally bedfast but lively. I spoke with the SW on the downlow as to which other hospice co that already serviced this NH might be better fit, she gave me 2 options. Met RN with 1 & she listened to my concerns & we together went to visit mom bedside & then we together went to nurses station to chat with them. This latter done to make sure the new hospice could deal with mom’s health care needs. All ok. I gave old group a written notice to cancel and did paperwork the new one had me fill out. I had not done paperwork for first hospice as medical director of the NH ordered it and all set in place with biggest hospice group that worked this NH. The paperwork was about 7 pages and you need a dpoa / mpoa unless your elder is cognitive enough to sign. Hospice #2 up & running within 3 days. Hospice paid by Medicare abt $4200-4500 a mo.
This part is important:
whatever equipment the old hospice has gotten for your mom will need to totally removed & be picked up. So you have to make sure new group brings in their new equipment ordered ahead of old stuff out. The new hospice group kinda has to have stuff at the ready to load up and haul over. Not all hospice are big enough to do this or have standing orders with equipment vendors to get delivery ASAP. New group had a much quieter pressurized mattress & frame brought in, ordered Geri chair and a Geri bathing chair (first hospice did not order these), nutritionals (twin cal RTF), disposable feeding bibs and met with dietary about switching to mechanized food menu choices rather than just puréed. Plus they could Skype me when the RN or Chaplin visited her & did!. Eons difference approach. Mom was on hospice a l...o...n...g 18 months & was never cleaner & bathed as she was once with this hospice group; they worked really well with the existing NH staff. Just awesome care. I did time the switch so that it was right before my mom’s next standard 90 day care plan meeting & the new hospice RN went to the care plan meeting with me. The new group saw a relatively smaller # of hospice patients at this NH & on retrospect that was much better.
If your doing in home hospice, I’ve heard that some groups will redline neighborhoods. And if your mom is on serious back box warning drugs, like on fentanyl, not all hospice will take that type of patient in an in home setting. Yeah totally can be done but with planning. Good luck!