Hospice care within a nursing home provides terminally ill patients and their families with extra layers of support. Hospice care includes expert management of pain and other symptoms, spiritual counseling, care planning, and grief support.

Hospice services provided in a nursing facility are covered by Medicare benefits. The hospice benefit includes resources and support for family and loved ones. Medicare hospice benefits do not cover room and board expenses.

In a Nursing home, staff have specialized training in custodial care, while hospice staff are experts at end-of-life care. Custodial care focuses on the activities of daily living, such as eating, bathing, and maintaining the quality of life. Meanwhile, hospice is comfort care to reduce the stress, pain, and other symptoms of a terminal illness. It is about helping patients and their families live as well as they can when life expectancy is limited.

A good number of people assume that if you are receiving care in a nursing home or residential facility that you do not need or cannot access hospice care at the end of life. Hospice is a program that provides care wherever clients live; it is not a place. Individuals can receive care at their place of residence; including their private home, nursing home, residential facility, or a hospice inpatient facility.

Also, people are afraid to lose their nursing home caregivers by enrolling in hospice care. If you live at a nursing home or assisted living facility, the hospice team will align with the staff there to provide additional services. Your Hospice team will coordinate your care with any other care providers you have and will not replace caregivers that you currently have relationships with.

Have it in mind there are many benefits to hospice care that will complement and add to the care you may receive at a nursing home. Most importantly, you will gain from the hospice team’s expertise on end-of-life issues and concerns. Note that the team will provide education and support around what to expect in the dying process and provide comfort measures for both clients and families.

Note that hospice care needs can vary for each patient and their loved ones. Every situation is unique. It is not unusual for doctors to hold off on a recommendation for this care giving approach until someone is already close to death, which means they miss out on the many benefits that are possible with this form of care.

Indeed, there are many misconceptions about hospice care that many people still believe all over the world. Some of this problem has to do with a general lack of awareness about the services and benefits that are available with this care giving option. That entails that some people fail to enter hospice care at all, leading to high under-utilization rates in many communities.

Although end-of-life care may be daunting and heavy to discuss, it is ideal for you to discuss your wishes before you and your family are in crisis. Furthermore, hospice care is most beneficial when started as early as possible affording adequate time for symptom and pain management and development of trusting relationships between patient, family, and hospice team.

Benefits of Hospice in Nursing Home Settings

In a nursing home setting, hospice helps patients, families, and nursing home staff by providing:

  • Steady visits by a hospice Registered Nurse to the nursing home.
  • Consultations by a specialized hospice physician as needed.
  • Expert management of pain and other symptoms, such as problems breathing or swallowing.
  • Education for nursing home staff, patients, and families about patients’ condition, symptoms, medications, and how to best care for patients’ medical needs during this phase of their illness.
  • Emotional and spiritual support for both the patient and their family during this phase of life. This includes help for the family before and after the patient dies.
  • Offer medications and supplies related to the patient’s terminal illness
  • Coordinating the patient’s care and medications across all of the patient’s medical providers, including the patient’s own doctors, hospice doctors, hospice nurses, hospice aides, and all nursing home staff.

Duties of a Nursing Home during Hospice

The nursing home is responsible for:

  • Communicating and coordinating patient’s care with the hospice.
  • Monitoring the patient’s condition and reporting any changes to the hospice.
  • The routine daily care for patients at the nursing home.
  • Normally scheduled medical care and examinations by the attending physician and medical director.
  • Providing medications and supplies for care not related to the patient’s terminal illness.
  • Keep in mind that hospice benefits do not usually cover the cost of housing a patient in a nursing home or assisted living facility (also known as daily room and board costs). However, these costs may be covered by traditional Medicare benefits or other benefits you have.

Hospice Eligibility Criteria for Patients in a Nursing Home

Patients in a nursing home or skilled nursing facility are eligible for the Medicare hospice benefit if they meet these criteria.

  • A doctor and a hospice medical director certify the patient has a terminal illness, meaning a life expectancy of six months or less
  • The patient signs a statement electing hospice care and waiving treatments for the terminal illness. Patients still receive treatment and care for other medical conditions
  • The nursing facility has a contract with a Medicare-certified hospice provider.
  • Patients may stop hospice and re-start medical treatments at any time


Hospice has the goal of improving the quality of the care received instead of prolonging a person’s life during the last phases of an incurable disease. The philosophy of hospice care is that it accepts death as the final stage of this life. It affirms the existence of each person without trying to postpone or hasten the expected terminal outcome.

For some patients with a terminal illness, their “home” is in a nursing home. A hospice may have contracts with some nursing homes in their vicinity to provide hospice care for patients in the nursing home. If you are interested in hospice care in a nursing home, ask your local nursing home which hospices they work with.

Frequently Asked Questions

  1. What Does Hospice Do In A Nursing Home?

In a nursing home, hospice assists the patients, families and nursing home staff in providing end-of-life resources and support. It also provides extra layers of support like spiritual counseling, care planning and grief support.

  1. Does Hospice staff Visit Nursing Homes?

Yes, hospice pays a regular visits to nursing homes.

  1. Does Medicare Pay For Hospice Care In A Nursing Home?

Yes, medicare pays for hospice care in nursing home.

  1. Who Pays For End Of Life Care In A Nursing Home?

About 85% of end-of-life care costs are usually paid by different government entities, which includes medicare, medicaid, and health care programs which are sponsored by the Veterans administration and the department of defense and also private medical and long-term care insurance.

This hospice costs are basically paid for, in the following the ways;

  • Medicare pays 85.4%
  • Medicaid pays 5%
  • Private insurance pays about 6.9%
  • Other charity or personal donation offer about 2.7%
  1. What Is Hospice Care In The Hospital?

Hospice offers medical and nursing care, which includes controlling of pain and other symptoms in the hospital.

  1. How Is Hospice Paid For In A Nursing Home?

Hospice is being paid by government programs and private insurance.

  1. Does Hospice Cover Nursing Care?

Yes, hospice covers nursing care because hospice can care or assist patients, families and even nursing home staff by providing end-of-life resources and support to them.

  1. Who Is A Hospice Nurse?

A hospice nurse is a health care professional that care for patients at the end of their lives. Hospice nurse usually works with terminally ill patients and helps to ensure their good (quality) life in their remaining days.

  1. What Does Hospice Provide At Home?

At home, hospice provides palliative care to relieve symptoms and give social, emotional and spiritual support to the patients receiving in-home hospice services.

  1. What Are Palliative Care And Hospice Care?

Palliative care is specialized medical care for people living with a serious illness, such as cancer or heart failure. Patients in palliative care may receive medical care for their symptoms, or palliative care together with treatment aimed at curing their serious illness.

Hospice care is focused on the caring, comforting and ensuring quality of life of a person with a serious illness who is approaching the end of life. Any patient under hospice care has no hope of recovering from illness, he or she might not be responding to medical attempts to cure the disease.

  1. What Qualifies A Person For Hospice?

What qualifies a person for hospice is when he or she is terminally ill, with at least six months or less of expected disease to run its course.

  1. Why Do Nursing Homes Push Hospice?

Reason is because hospice is a place where skills and services that are not available in nursing homes are provided terminally ill patients.

  1. What Is The Criteria For Skilled Nursing Care?

The criteria for skilled nursing care are;

  • Injury cure
  • Therapy nutrition
  • Cardiac care
  • Pulmonary rehabilitation
  • Post-stroke recovery
  • Physical therapy programs
  • Professional therapy
  1. What Services Do Hospice Care Provide?
  • Home-health aide
  • Counseling services
  • Medical social services
  • Nursing services
  • Medication
  • Therapy
  • Respite care
  1. What Happens If Someone Under Hospice Care Lives Longer Than Six Months?

If a patient under hospice care lives longer than expected, probably more than six months, the patient will no longer be eligible for hospice care.

  1. What Services Does The Hospice Program Provide?

Hospice program provides the following services;

  • Community-based services
  • Psychological and social support
  • Rehabilitation
  • Complementary therapy
  • Spiritual care
  • Pain and symptom control
  1. How Do You Find The Right Hospice Care Agency?

You can find the right hospice care agency by the following means;

  • Get an assessment of the agency qualifications
  • Find out what patient services are offered
  • Inquire about family support
  • Take proper documentation
  • Get relevant opinions
  1. What Are The Benefits Of Hospice Care?

Some of the benefits of hospice care are;

  • It Provides a comprehensive plan
  • It offers Personalized care and support
  • It gives patients a sense of dignity
  • It respects a Patient’s Wishes
  • It lessens Financial Burdens
  • It Provides family Counselling
  • It Offers a familiar environment
  1. What Is Covered Under Medicare Hospice Benefit?

Doctor service is covered under medicare hospice benefit.

  1. What Are The 4 Levels Of Hospice Care?

The four levels of hospice care are;

  • Respite care
  • Inpatient hospice care
  • Hospice care at home
  • Continuous hospice care
  1. How Does Hospice Help Dementia Patients?

Hospice helps dementia patients by comforting and giving them some sense of dignity before they die.

  1. How Do You Know When A Person Is Ready For Hospice?

You can detect when a person is ready for hospice by the following means;

  • Recurring infections
  • Regular hospital visitation
  • Uncontrollable pains, nausea, or vomiting
  • Loss of urinary
  • Chest congestion and rapid breathing
  • Loss of appetite
  • Changes in body temperature
  • Restlessness
  • Dizziness
  1. Who Makes Up The Palliative Care Team?

Palliative care team are made up of medical, nursing and allied health professionals who offer a range of services to assist you, your family and carers throughout your illness. In some cases, volunteers can also offer practical and emotional support.

  1. What Is The Difference Between Hospice Care And Palliative Care?

Despite the similarity in services, the significant different between palliative care and hospice care is, palliative care can begins its services by diagnosing the patient and also treat at the same time. While Hospice care begins after treatment of the disease, with obvious fact that the person is not going to survive the illness.

  1. How Often Will A Nurse Or Other Hospice Staff Visit?

Visiting time for nurses and hospice staff depends on patient and family needs. Most patients are initially seen by a nurse twice or thrice per week. Visit may become more or less frequent based on the needs of the patient and family.

  1. Does Hospice Take Your Social Security Check?

No! Reason is because they are always at home, so will continue to receive their SSI.

  1. Which Is Better Hospice Or Nursing Home?

In as much as nursing homes are doing great services and care, but hospice care is considered as the best in treating end-of-life pain and suffering and also the quality and the ability to provide support for the patient and their families.

  1. How Do You Pay For Hospice Care?

Patients with a terminal illness do not usually have to pay for hospice care. Hospice care charges are usually covered by Medicare.

  1. What Are Some Similarities Between Palliative Care And Hospice Care?

Some similarities are;

  • Both provide relief and comfort
  • Both render services to patients
  • Both provide the basic needs of the patients
  1. How Often Do Hospice Aides Visit?

One to three days in a week.

  1. Does Hospice Help With Bathing?

Yes, hospice can assist in bathing a patient whose condition is more critical than normal case.

  1. What Are Some Additional Factors To Consider About Hospice Care?

Some additional factors to consider about hospice are;

  • Ability to serve in various locations
  • Stellar Satisfaction Scores
  • Difference Levels of Care
  • Multiple Facets of Support
  • Full-time Physicians as staff
  • Professional Certification
  • Assistance that is readily available
  1. How Long Will Medicare Pay For Hospice Care?

Six months. But if a patient lives longer than 6 months, he can still get hospice care, as long as the hospice medical director or other hospice doctor re-certifies that he or she is terminally ill.

  1. How Long Does The Average Hospice Patient Live?

It is really unpredictable on how long a hospice patient can live, because health issue differs, any patient who was younger than 65 when he or she was enrolled can possibly die within six months.

  1. How Much Does Hospice Care Cost?

The price range for hospice care is basically within the range of $150 (for home care) and $500 (for general inpatient care) per day.

  1. Where Is Palliative Care Provided?

Palliative care is usually provided in hospitals, nursing homes, outpatient palliative care clinics and some other specialized clinics.

  1. Who Can Benefit From Palliative Care?

The beneficiaries of the palliative care are all the patients who are critically ill regardless of the patient age, prognosis, disease stage, or even treatment choice.

Solomon. O'Chucks
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