Can someone explain hospice care in nursing home?

Usually the hospice doctor will
lead the care but you can choose to have her doctor involved if
he is agreeable. Make sure you are onboard with hospice philosophy and educate yourself by asking questions. Many more services are available through hospice, more than the facility can offer. I say the more care that can be offered the better.

They work together. Hospice is not there everyday. A nurse comes in maybe 3x a week. Not sure if an aide does since the facility has them. But Hospice is in charge of Medications. What will be kept and what will be given. They have their own Doctor associated with them so he writes up the orders.

When Hospice is not there, then the NH is responsible for her care.

My mom was in a NH for several years and on Hospice there at the very end.

The nursing home continued to provide care at the same level (meals, hygeine, bathing, med administration). She was under the care of the Hospice MD but it was the NH nurses and med techs who administered morphine.

It is certainly worthwhile to interview several Hospice providers and to talk to the Director of Nursing at the NH to find out who they are comfortable working with.

I am so sorry that you are facing this tough decision.