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Mostly Independent
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Hospice has to come up with the right "Medicare Code" for your mother, and I do believe Alzheimer's Disease is one of them. My mother had vascular dementia, which is not a "Medicare Code" for hospice, in and of itself, so the nurse had to get creative, and came up with "Senile Degeneration of the Brain" to use as a valid "Medicare Code" to get mom approved for hospice care last December.
So yes, Medicare will cover hospice care costs for an advanced AD patient.
lealonnie1 my mom's doctor used this same medicare code of "Senile Degeneration of the Brain" for hospice admission. Otherwise she wouldn't have qualified.
Yes, but first the patient must be accepted by Hospice. That means that a doctor must "recommend" Hospice and must vouch for the fact that, in his opinion, this patient has likely less than 6 months of life remaining, and faces now the end of life for a condition that cannot be successfully treated. THEN the Hospice must do interviews and assessment and "accept" the patient, indicating that Hospice agrees with the doctor. Often today things get fudged for the extra care Hospice represents. If the patient is still living at the end of 6 months there is a reassessment for Hospice, and on things go. The POA should discuss this with the treating MD.
Hospice is covered by Medicare, Medicaid and most all other Insurance. It will cover in home Hospice. If the patient is in a facility the "room and board" will not be covered though.
This is being done because the person is “in patient” in a facility. Being “in patient” is beyond different than being a “resident” at a facility.
Its not the average hospice situation. Folks need to realize this as it gives false hope to families wallets….
If you do not realize the difference, please hang with me on this as it’s not straightforward…. Hospice is 100% a MediCARE benefit. Wherever hospice is done. HOWEVER MediCARE will not and does not pay for custodial care. Custodial care, e.g. the room & board costs to be in a bed in a NH is private pay, or LTC insurance or via LTC Medicaid. The room & board costs for AL or MC is private pay unless your state pays for these under a Medicaid waiver program. BUT MediCARE will pay the costs - including the daily bed costs - for anyone considered “in patient”; so Medicare pays if you are in-patient at a hospital, or in-patient in a NH for rehab, or are in-patient in an acute care facility. The acute care facility tend to be LTACH - Long Term acute care hospital (Kindred is a big player for LTACHs). BUT… there are smaller places that will have a small limited set # of in-patient beds that are Acute Care and so are MediCARE eligible as it is more intensive medical supervision that could ever be provided at home or in a NH or MC. It is end of life care so Medicare hospice benefit can be billed as well and it’s intensive medical oversight so MediCARE hospitalization benefits can be billed. So costs covered fully by Medicare.
These are not the usual in a NH or MC type of elders who are there under custodial care and oversight. MediCARE won’t pay for room&board or bed costs on this population. They are instead those with significant medical issues so need “in-patient” care which MediCARE will cover.
Samaritan - if this the one in NJ - mentions this in their website. Where I am, Catholic Charities has a big in-patient hospice facility. Where I grew up, VITAS has a couple of in-patient hospice both freestanding and within a couple of NHs. My late MiL got bad pneumonia at her NH then went into the hospital got worse, got sepsis and cascading organ failure then moved as “in-patient” into a LTACH and under hospice that was adjacent to the hospital, was there a. 3 weeks then died. MediCARE will pay for all this as serious involved health care needing medical / MD supervision. But this is not what most who are on hospice are at; most get their hospice benefit limited to durable medical equipment hospice brings in (pneumatic mattress, geri chairs) and a hospice caregiver dropping by 2 or 3 times a week, checking vitals, helping with bathing, medication management type of stuff. Hospice Chaplin & their RN coming by once or twice a mo.
Medicare is not going to pay for room&board at a facility.
Medicare WILL NOT pay room and board for in home care or nursing home. If your hospice team determines you need short term in patient care (majority of patients) or respite care Medicare WILL PAY for your stay at the facility including room and board.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
So yes, Medicare will cover hospice care costs for an advanced AD patient.
Good luck to you.
Often today things get fudged for the extra care Hospice represents. If the patient is still living at the end of 6 months there is a reassessment for Hospice, and on things go.
The POA should discuss this with the treating MD.
It will cover in home Hospice. If the patient is in a facility the "room and board" will not be covered though.
Its not the average hospice situation. Folks need to realize this as it gives false hope to families wallets….
If you do not realize the difference, please hang with me on this as it’s not straightforward…. Hospice is 100% a MediCARE benefit. Wherever hospice is done.
HOWEVER
MediCARE will not and does not pay for custodial care. Custodial care, e.g. the room & board costs to be in a bed in a NH is private pay, or LTC insurance or via LTC Medicaid. The room & board costs for AL or MC is private pay unless your state pays for these under a Medicaid waiver program.
BUT
MediCARE will pay the costs - including the daily bed costs - for anyone considered “in patient”; so Medicare pays if you are in-patient at a hospital, or in-patient in a NH for rehab, or are in-patient in an acute care facility. The acute care facility tend to be LTACH - Long Term acute care hospital (Kindred is a big player for LTACHs).
BUT…
there are smaller places that will have a small limited set # of in-patient beds that are Acute Care and so are MediCARE eligible as it is more intensive medical supervision that could ever be provided at home or in a NH or MC. It is end of life care so Medicare hospice benefit can be billed as well and it’s intensive medical oversight so MediCARE hospitalization benefits can be billed. So costs covered fully by Medicare.
These are not the usual in a NH or MC type of elders who are there under custodial care and oversight. MediCARE won’t pay for room&board or bed costs on this population.
They are instead those with significant medical issues so need “in-patient” care which MediCARE will cover.
Samaritan - if this the one in NJ - mentions this in their website. Where I am, Catholic Charities has a big in-patient hospice facility. Where I grew up, VITAS has a couple of in-patient hospice both freestanding and within a couple of NHs. My late MiL got bad pneumonia at her NH then went into the hospital got worse, got sepsis and cascading organ failure then moved as “in-patient” into a LTACH and under hospice that was adjacent to the hospital, was there a. 3 weeks then died. MediCARE will pay for all this as serious involved health care needing medical / MD supervision. But this is not what most who are on hospice are at; most get their hospice benefit limited to durable medical equipment hospice brings in (pneumatic mattress, geri chairs) and a hospice caregiver dropping by 2 or 3 times a week, checking vitals, helping with bathing, medication management type of stuff. Hospice Chaplin & their RN coming by once or twice a mo.
Medicare is not going to pay for room&board at a facility.