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Doctor insights on: Skilled Nursing Vs Hospice

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Why is hospice located in skilled nursing facilities?

Why is hospice located  in skilled nursing facilities?

High level needs: Hospice is extremely useful in skilled nursing facilities for patients who have a high symptom burden and cannot be managed at home or do not have a home or home caregivers that allow for this. Hospice clinicians are specially trained to deal with symptoms and generally add expertise to the staff at skilled nursing facilities because the patient will get extra attention. ...Read more

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Hospice (Definition)

All hospices deliver a similar set of services. They include nursing, assistance with caregivers on a limited basis, chaplaincy, bereavement counseling, social worker and physician care (medical director in many cases). You are covered for many services and this includes medications related to your terminal diagnosis. The hospice team is there to help you transition in the ...Read more


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Would the hospice give better care in a nursing home?

Would the hospice give better care in a nursing home?

Palliative/ Hospice: Hospice serves pts in their own homes, nursing homes, long-term care or assisted living facilities or hospitals. Pts receive palliative care to ease pain, and discomforting symptoms; psycho-social, and spiritual support. Hospice care is focused on maintaining dignity, increasing quality of life, and providing comfort , including pain and symptom management. Hospice gives best care at end of life ! ...Read more

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Does hospice care offer full-time nursing care?

Does hospice care offer full-time nursing care?

Hospice: Hospice is an end of life service through medicare or private insurance. It will not pay for 24/7 care unless the person is in the active dying process of the last few days. If you need care in the home you should hire an in home care agency. This is private pay and not covered by medicare. Some long term care insurance may cover it. Check with your agent. ...Read more

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If pt. is D/C'd back to a RCFE but now receives nursing services from a hospice, does this mean end of life care? Pt. had aspirational pneumonia.

If pt. is D/C'd back to a RCFE but now receives nursing services from a hospice,  does this mean end of life care? Pt. had aspirational pneumonia.

If true hospice care: Yes, if it is true hospice care. However, some hospice services also provide "bridge care" for patients whose end is not quite in sight yet (it's like palliative care). Hospice services are a wonderful asset to have at the end of one's life. We all have an end. When our end is in sight, hospice is the way to go. It lets one die a good death, at home, pain-free, worry-free, in peace and quiet. ...Read more

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Dementia pt. had aspirational pneumonia D'C'd back to RCFE even tho needs higher level of care. Nursing scvs provided by hospice. Why not sent to SNF?

Dementia pt. had aspirational pneumonia D'C'd back to RCFE even tho needs higher level of care. Nursing scvs provided by hospice. Why not sent to SNF?

A different focus: Hospice services are a wonderful asset to have at the end of one's life. We all have an end. When the end is near, we don't go to a skilled nursing facility (think of an SNF as a place to recover and get back to good mental and good physical functioning). When our end is in sight, hospice is the way to go. It lets one die a good death, at home, pain-free, worry-free, in peace and quiet. ...Read more

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Mrs. Rose is a hospice patient in the nursing home. She has gangrene of her foot. What can she do to cure it?

Mrs. Rose is a hospice patient in the nursing home. She has gangrene of her foot. What can she do to cure it?

It depends: Depending on her current health status, whether the gangrene is wet/dry, if there is neuropathy (which may spare the patient pain), and prognosis are to all be considered. Hospice care is palliative in nature, so if intervention for the gangrene is to be considered, a change in her hospice status is necessary. ...Read more

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My mom 89, had severe dementia and was yelling out. Hospice, nurs. Home and state tried morphine in case she was in pain. 1/5 of a tsp every 2 hours as needed. 2 days later she died is morph. Cause?

My mom 89, had severe dementia and was yelling out.  Hospice, nurs. Home and state tried morphine in case she was in pain.  1/5 of a tsp every 2 hours as needed.  2 days later she died is morph. Cause?

Morphine: Morphine is often used for respiratory distress and agitation from lack of oxygen in a terminal disease. It is difficult to answer your question because the amount and frequency of the morphine dosing during this time period is not provided in your question. I would discuss your concerns with the medical provider so you can gain understanding and closure from your loss. ...Read more

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What are the factors that need to be considered in determining whether or not someone needs to go to a skilled nursing facility?

What are the factors that need to be considered in determining whether or not someone needs to go to a skilled nursing facility?

24/7 care: the key thing is not able to maintain independently - medications, self care, daily routine such as bathing, clothing, toileting, household activities, lack of availability to provide supervision, lack of financial resource available, lack of family commitment to care for and the distance between two locations. Security of health and safety are another factors ...Read more

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Reimbursement for skilled nursing from medicare?

Reimbursement for skilled nursing from medicare?

21 days: Medicare will pay for post hospital care in a rehab facility generally 21 days and possibly more with a co pay.Medicare does not pay for long term care. ...Read more

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Will all skilled nursing facilities provide IV therapy?

Will  all skilled nursing facilities provide IV therapy?

Usually not: Some nh who have rn round the clock can administer IV medications. Most of them do not provide this service. ...Read more

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Mom needs to go to skilled nursing for rehab. What questions should I be asking?

Mom needs to go to skilled nursing for rehab. What questions should I be asking?

What kind available: Depends on what she is rehabilitating from. The care needed for recovering from a stroke is different than from a heart attack or serious illness. Ask about their success with your mother's problem, what services are available, hw often care provided. Cost is a big issue too, and must be addressed. It is a good idea to go check the place out yourself to see it and meet the staff. ...Read more

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What if you are in a skilled nursing facility and dr's orders are not being followed but makes in your chart that it was done?

What if you are in a skilled nursing facility and dr's orders are not being followed but makes in your chart that it was done?

Violation: If you are certain that something is supposed to be done and it's not being done, bring this up to the nurse supervisor. They will supervise whether something is supposed to be done or not. If the problem persists, bring the problem to the patient liaison for investigation. Your job is to make sure that things are being done and your health is being looked after. ...Read more

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What are skilled nursing facilities?

What are skilled nursing facilities?

Level of care needed: A skilled nursing facility describes a center catering to the needs of patients who need a level of care sometimes requiring the skills of a nurse but not that of a hospital. Included are those needing help with body functions, feeding, medications or mobility at various ages. Generally, a treatment plan coordinated with a physician monitored by the nurses is part of the process. ...Read more

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Are skilled nursing facilities covered by medicare?

Depends: In california if a patient has been in the hospital for at least 72 hours, a patient quailifies for rehabilitation services which is covered by medicare part a. Once the "part a days" are used or the person no longer is benifitting from rehab, then the person is discharged home. If the person needs to stay to live, either family pays for room & board or medicaid covers this. ...Read more

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What is difference between assisted living and skilled nursing center and nursing home?

What is difference between assisted living and skilled nursing center and nursing home?

Levels of care: The highest level of care is delivered in the hospitals. Out of the hospital the highest level of care is in a skilled nursing facility that can give complete custoidial care including total patient assistance with daily living, giving medications and intravenous therapy, and all necessary care. The next level of care are assisted living homes that can help people who need less nursing care. ...Read more

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What changes have occurred in assisted living and skilled nursing facilities in preparation for boomers/?

What changes have occurred in assisted living and skilled nursing facilities in preparation for boomers/?

See below: 20 yrs ago, seniors and their families had few options to turn to for long term assistance and support other than expensive, institutional-like nursing homes. Obamacare and other tweaks in the healthcare laws may allow seniors greater access to resident-centered options/in a facility that seems more like a residence than a hospital. ...Read more

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Urgent: will have been in skilled nursing 3mo tomorrow. Daughter just said need to be seen 3x in 3mo but no appt till next wk. Will medicare cancel?

Urgent: will have been in skilled nursing 3mo tomorrow. Daughter just said need to be seen 3x in 3mo but no appt till next wk. Will medicare cancel?

Ask the billing guy: Questions about medicare coverage while in a skilled nursing facility can go to the billing / finance person at the facility. Medicare is government insurance, and has strict rules on what it covers. There are some exceptions, but as with any medical insurance, if the insurance does not cover it, then the patient pays for it. It's best to figure out what to do well before any 90-day limit arrives. ...Read more

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How do a skilled nursing facilities make money?

How do a skilled nursing facilities make money?

Medicare Part A: The biggest factor in how skilled nursing facilities make money is the number of patients receiving rehab services under medicare part a. This level of service reimburses the most and nursing homes go to great lengths to try and have as many patients on rehab as possible. They also make money on patients who are custodial care (live there) however the margin of profit is small. ...Read more

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Help please? What is a skilled nursing home?

Help please? What is a skilled nursing home?

Specialized services: A skilled nursing home offers more than custodial services. They also provide physical and occupational therapy, dietary services , and give services such as respite care, feeding tubes, continue IV therapy. Usually a doctor is assigned to patients and psychiatrist will also follow patients with psychotropic medications. ...Read more

Dr. Lonnie Smith
8 doctors shared insights

End Of Life Care (Definition)

Care that is palliative, ie symptom support , but no treatment of ...Read more