Finding out that a loved one has an incurable condition is never easy. Having others to lean on can make all the difference, and that’s where hospice care comes in. At its heart, hospice is about support at the end of life, but many people in Cincinnati, Ohio, don’t really understand how it works.
After entering hospice, terminally ill individuals have the help they need to live out their remaining time as comfortably and independently as possible. Family members also benefit from the support of hospice. However, there is no one-size-fits-all approach – with hospice care, services are customized to the client. And, a team of skilled professionals, including physicians, nurses, therapists, counselors, chaplains and trained volunteers, collaborates to ensure comprehensive care.
The Centers for Medicare and Medicaid Services (CMS) identifies four levels of care, and patients may experience any or all of them during their time in hospice. Here’s a brief look at what each level involves.
Hospice Care at Home
Officially known as routine home care (RHC), hospice care at home is exactly that – hospice services provided at the patient’s home. As some eligible individuals live with family members and others reside in nursing facilities and assisted living centers, those places can also serve as the setting for routine home care.
Hospice care at home, which accounts for over 97 percent of hospice services provided, allows a patient to spend their final days in a comfortable and familiar environment. Medication, medical equipment and medical supplies are provided, and members of the interdisciplinary hospice team conduct regular visits to manage the patient’s care. Most day-to-day concerns are addressed by the family, but Cincinnati hospice care providers are always on call to assist with any patient or caregiver needs.
Continuous Home Care
Also known as crisis care, continuous home care (CHC) is for patients who need more intensive medical attention. At this level, members of the hospice team come out to provide support at the individual’s home, wherever that may be, with the aim of getting them stable enough for routine home care services to resume.
Continuous home care is only offered when a patient has urgent, short-term medical needs that cannot be met by family caregivers. Uncontrollable pain, persistent nausea, trouble breathing, new onset seizures and problems swallowing food are a few of the symptom crises that may call for this hospice service. However, less than one percent of hospice care services delivered nationwide are at the CHC level, and it isn’t all that common among patients in the Cincinnati area.
In-Patient Hospice Care
When problematic symptoms cannot be managed in the home setting, in-patient hospice care – or general in-patient care (GIP) – offers a solution. Provided outside the home, typically at a local skilled nursing facility or hospital, this level represents about 1.7 percent of hospice services provided throughout the country.
Transitioning to in-patient hospice care may be necessary in the event of respiratory distress, unmanageable agitation or a sudden decline in health. Individuals who need intravenous medication or close monitoring might also need this hospice service. As with the CHC level, the goal of general in-patient care is to provide the right support to allow for a return to hospice care at home. In Cincinnati, Ohio, GIP is generally utilized for only a few days, but the service can be provided for a longer period.
Respite Care for Caregivers
Unlike the RHC, CHC and GIP levels of hospice care, this level – referred to as in-patient respite care (IRC) by the Centers for Medicare and Medicaid Services – is tied to the needs of family caregivers. Tending to a loved one who is terminally ill is incredibly challenging, and IRC offers a break.
With respite care, the hospice patient is transferred to a skilled nursing center or hospital for up to five days, releasing their caregiver from their regular duties. In Cincinnati, many people take advantage of IRC when they’re emotionally exhausted, physically fatigued or under the weather. That said, family caregivers who want to attend weddings, graduations, retirement dinners, class reunions and other special events can also request respite care.
Are All Four Levels of Hospice Care Covered by Medicare?
Medicare does cover all four levels of hospice care, assuming the patient is eligible – meaning that they have a doctor-certified terminal illness, a presumed prognosis of six months or less and a willingness to forgo further curative treatment. And, hospice services must be provided by a Medicare-approved agency.
Medicaid also offers coverage for RHC, CHC, GIP and IRC services, and for individuals who are dual-eligible, Medicaid covers some of the costs that aren’t included in the Medicare hospice benefit.
With Medicare Advantage plans, the coverage rules are complex. Some benefit packages offer additional services not available under standard Medicare or Medicaid coverage, but MA plans can also impose out-of-pocket charges. For details on what is and isn’t covered, patients or their families can ask their plan provider.
And, of course, Suncrest is always here to help. If a loved one in Cincinnati, Ohio, has been diagnosed with a terminal illness and you’d like to know more about how hospice care works, contact us today.
