Lecture: Hospice and Medicare

Introduction

• Speaker: Marvin from medicareschool.com
• Guest: Russ Rogers, hospice expert
• Topic: Hospice care under Medicare

Importance and Prevalence of Hospice

• 2 million people on Medicare receive hospice benefits yearly
• Medicare spends $22 billion annually on hospice care
• Increasing relevance due to aging population (e.g., Baby Boomers)

Guest Introduction: Russ Rogers

• Started in hospice 15 years ago
• Initially attracted by business prospects due to Baby Boomers
• Shifted focus to patient and family care after witnessing impact
• Operates in Kansas, Missouri, Oklahoma, Colorado

Hospice vs. Palliative Care

• Palliative care is for those who qualify for hospice but are not ready to acknowledge it's end-of-life
• Less intensive than full hospice care
• Includes elements like case manager, nurse practitioner, chaplain, and social worker
• Hospice care: Patients expected to live six months or less

Hospice Qualifying Conditions

• Requires terminal diagnosis with six months or less life expectancy (subject to reassessment)
• Common conditions: Alzheimer's, dementia, COPD
• Review process every 6 months initially, then quarterly
• Hospice care can extend beyond six months if patient remains in decline

Interdisciplinary Team in Hospice

• Core Team Members:
  • Physician: Oversees patient care
  • Case Manager: Registered Nurse (RN), supported by LPN
  • Chaplain: Provides spiritual care
  • Social Worker: Manages administrative/legal tasks (e.g., living wills)
  • Hospice Aid: Provides hands-on care, helps with daily tasks
  • Volunteer: Offers companionship and non-medical support

Levels of Hospice Care

• Hospice care can be provided at various locations: home, skilled nursing facility, assisted living facility
• Care types: Routine home care, continuous care, inpatient care, respite care
• Continuous Care: 24/7 at-home care, requiring nurse presence 50% of the time
• Respite Care: Temporary relief for caregivers, up to 5 days in a care facility

Financial Coverage of Hospice

• 100% covered by Medicare (excluding luxury items like electric chairs)
• Includes medications, durable medical equipment (DME), nursing care
• Additional supplemental and advantage plans: Hospice benefit reverts to original Medicare

Special Care for Veterans

• Commitment to veteran care through National Hospice and Palliative Care Organization’s “We Honor Veterans” program
• Trainings for staff on veteran-specific needs
• Ceremonial practices and veteran recognition events

Christian Business Philosophy

• Operates under Christian principles: dignity, respect, honesty, commitment
• Focus on exceptional patient care as a guiding principle
• Emphasis on training, veterans, and specific care areas like wound management

Choosing the Right Hospice

• Research and compare online ratings (Google, Medicare websites)
• Look beyond basic requirements: specialized care offerings, training programs
• Important metrics: Nurse-to-patient ratio (ideally 10-12), time spent with each patient

Conclusion

• Importance of comprehensive and compassionate hospice care
• Value of hospice benefit for patients and families
• Encouragement to utilize and choose the right hospice service based on individual needs