Levels of Care
Routine Home Care
Routine home care is the care provided by Hospice in the patient's home, which may be a residence, an assisted living facility, a long-term care facility, nursing home or wherever the patient is located.
Hospice Routine Home Care in the Nursing Home
As people approach the end of life, additional services are always needed. Everyone has the right to receive hospice services while residing in a nursing home. Supplemental care by the Hospice Team enhances quality of life for the patient and family. Hospice provides services in addition to what is provided by the nursing home. Hospice staff work closely with nursing home staff to ensure that the patient is getting what they need and deserve. The HospiceTeam provides routine home care in the nursing home, just as it would if the patient were living at home. For a list of nursing homes contracted with Hospice of Palm Beach County, click here. Hospice is a covered benefit under Medicare, Medicaid and most insurance companies, but is always separate from room and board charges. The cost of room and board is the responsibility of the patient and/or family, just as if the patient were residing at home paying rent or mortgage payments.
Hospice inpatient care, often referred to as general inpatient care, acute care or hospitalization, is available for patients who are experiencing acute or severe pain or symptoms that cannot be adequately managed in the patient's home. Patients may be admitted for a limited time (generally 3-7 days) to a Hospice Inpatient Unit, hospital or skilled nursing facility that is contracted with Hospice of Palm Beach County to provide such service. The Hospice Inpatient Units are located in Palm Beach County: Charles W. Gerstenberg Hospice Center, 5300 East Avenue in West Palm Beach, and Hospice of Palm Beach County Hospice & Palliative Care Unit at Good Samaritan Medical Center, both in West Palm Beach, the Jay Robert Lauer Hospice & Palliative Care Unit located on the sixth floor at the JFK Medical Center in Atlantis, Bethesda Memorial Hospice & Palliative Care Unit at Bethesda Memorial Hospital, Boynton Beach, Hospice and Palliative Care Unit at Palm Beach Gardens Medical Center, Palm Beach Gardens, Hospice and Palliative Care Unit at Pinecrest Delray, Delray Medical Center, Delray Beach. Inpatient care is determined and arranged by the Hospice Team. Any inpatient care not pre-approved by the Hospice Team will be the responsibility of the patient and/or family.
Respite Care
This level of care is most commonly used when the patient's caregiver(s) would benefit from some relief from the day-to-day care they provide at home. Respite care is limited to a maximum of five (5) consecutive days at any one time. Respite care is arranged by the Hospice Team and provided in an approved facility.
Continuous Care
Continuous care is provided to patients during a crisis period as necessary to maintain the patient at home. Nurses and Certified Nursing Assistants monitor acute symptoms that require more intensive and continuous nursing care than is generally provided under routine home care. Other members of the Hospice Team may also provide care during this time.
Routine home care, respite care, continuous care and inpatient care are available to all patients including those who have elected their Medicare or Medicaid Hospice Benefit and to patients who have this benefit through a third party payer. Hospice provides all medications, services, supplies and equipment that are related to the patient's terminal diagnosis as outlined in the patient's individual plan of care.
Hospice of Palm Beach County has a pharmacy located at the Charles W. Gerstenberg Hospice Center, which supplies most prescription medications. The Hospice Nurse routinely checks each patient's medication supply and orders medications as needed. Medications may be picked up at the Gerstenberg Center Pharmacy or will be delivered weekdays by a contracted courier. Please call your Team to make arrangements to receive medication. Medications included in the plan of care are covered by Hospice. Medications not related to the terminal illness are not covered by Hospice but may be covered by your health plan. For specific benefit information, please refer to your insurance policy or ask to speak with a Hospice Insurance Case Worker for assistance.
Medical Equipment and Supplies
Durable medical equipment (DME) and supplies will be made available to all patients as outlined in the plan of care. Your Hospice Nurse will recommend what equipment would be most beneficial to you and will arrange for delivery of the equipment to your home. Most medical supplies and other items needed for your care will be brought to your home by your Hospice Nurse. Equipment and supplies not related to the terminal illness are not covered by Hospice but may be covered by your health plan. If at any time you need additional equipment or existing equipment is not functioning as expected, contact your Hospice Nurse who will be glad to resolve the problem as soon as possible.
Medicare covers all services and supplies for the hospice patient. In some hospices, the patient may be required to pay a 5% or $5 co-payment for medication and respite care. You should find out about any co-payment when considering a hospice. Hospice of Palm Beach County does not charge this co-payment. To be eligible for the Medicare Hospice Benefit, a patient must be entitled to Medicare Part A benefits and must be certified as terminally ill, defined by the Medicare Hospice Regulations as having "a medical prognosis with a life expectancy of 6 months or less if the disease follows its normal course, as certified by a physician." Medicare Part A covers the Hospice Benefit, which consists of four levels of care: routine home care, hospice inpatient care, continuous care and respite care. Medicare beneficiaries who are HMO members are entitled to use their Hospice Benefit and may choose any hospice provider while remaining an HMO member. Federal regulations require certification periods for Hospice Medicare and Medicaid patients, which consist of an initial 90-day period, a subsequent 90-day period, followed by an unlimited number of 60-day periods. At the conclusion of each benefit period, the Hospice Nurse will reassess and a Physician will re-certify the patient's continued eligibility for the Hospice Medicare or Medicaid Benefit. The patient may elect to stop hospice services at any time and revert to his/her previous Medicare benefit. Any remaining days in a hospice benefit period are forfeited once hospice care is stopped. However, a patient can re-elect the next benefit period at any given time. If a patient no longer meets the requirements to be eligible for the Hospice Medicare or Medicaid Benefit, members of the Hospice Team will assist in reinstating the patient's regular Medicare or Medicaid benefits. They will also make sure the patient and family are referred to the appropriate healthcare provider. If you have any questions, please ask your Nurse. Hospice care is available to anyone regardless of age or financial status. Remember, hospice coverage is for the life-limiting illness only. Any other illness or diagnosis not related to the life-limiting illness is handled under the patient's regular insurance plan.
Most insurance plans provide a hospice benefit similar to Medicare. Hospice staff are available to assist inverifying insurance coverage for hospice services. Remember, hospice coverage is for the life-limiting illness only. Any other illness or diagnosis not related to the life-limiting illness is handled under the patient's regular insurance plan.
