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There are some differences in how original Medicare and Medicare Advantage plans pay for hospice and home health. Hospice is for patients and families who need additional support for their loved ones who can no longer go to outpatient medical appointments due to infirmity or terminal illness. Hospice care provides pain and symptom management for people with a terminal illness who aren’t expected to live longer than six months. For home health patients, medicare doesn't cover personal care services.
Not everyone falls into a distinct category when they are ill and declining. Here are some guidelines on who hospice and home health are for, but always consider that the lines are blurred.
Insurance Coverage
HOME HEALTHHome health care patients are recertified after each 60-day episode of care. The first two recertification periods are 90 days; after that, the patient must be recertified every 60 days. There is no limit to the number of times a patient can be recertified, as long as the physician’s prognosis is six months or less from the time of recertification. Social Work—Similar to chaplain work, many people facing end-of-life situations spend time evaluating the life they lived and what emotions they may still be holding on it. Social work is provided to hospice patients to help face these feelings and provide a safe space to discuss openly and hopefully reduce any lingering emotional pain.
CMS will require hospice surveys to be conducted by multidisciplinary teams, as well as implement a redesigned surveyor training process and new protections against conflicts of interest. Surveyors from accreditation organizations with deeming authority will now have to undergo the same training as those employed by government agencies and use similar assessment forms during surveys. Numerous hospice providers have expressed support for efforts to stem this problem, though many retain the trepidation that good, ethical providers might be caught in the crossfire. A coalition of hospice industry organizations recently urged the U.S. Centers for Medicare & Medicaid Services to examine the issue and to consider actions like targeted moratoria on licenses. A number of hospice leaders anticipate that the industry will settle into a “new normal,” having absorbed the shock of the pandemic with a better understanding of how to navigate the transformed landscape.
Can You Have Hospice And Home Health?
Hospice care provides medical supplies, medical, social, emotional, and spiritual care for the patient and his family, medicine management, and bereavement support for immediate family members. Hospice care can be provided wherever the patient calls home, as well as in-patient facilities. Do you have an aging or ill parent, grandparent, loved one or friend?
After the patient has passed away, social work continues working with families to help alleviate the grieving process. There are many services available to home health patients, and they are all covered 100% by Traditional Medicare and several other insurance providers (so no cost to you!). The purpose of home health care is to help you regain your independence and to get you back on your feet, so all of the cares we provide are catered towards that overarching focus. Not every patient chooses to receive all the services ordered by their physician, but they are available to help our patients heal at a more accelerated rate than they would have been able to without. Home health care visits are based on the needs of the patient and caregiver. They typically decrease over time as the patient’s health improves and their needs decrease.
Health
Hospice care includes specialized care by a team of professionals who are trained to manage physical, emotional and spiritual comfort for those who are in the last stages of chronic illness. There are benefits to both home health care and hospice care, but these benefits are not the same. They should both be looked at carefully in order to determine the best path for you or your loved one. In some cases, home health and hospice services can be used simultaneously. Home health care is typically prescribed for treatment of a chronic condition or to help a patient recover from surgery or an injury. Unlike hospice, a patient must be homebound to receive Medicare benefits for home health services.
These benefits can reach well beyond the physical needs of a patient and extend into their spiritual and psychosocial needs, even taking care of needs for the family. The main difference between hospice and home health is that hospice is for people with a terminal illness who aren’t expected to live longer than six months. Home health is for people who need help recovering from an illness, injury or surgery or managing a chronic health condition. There are also differences in the services provided, eligibility criteria, visit frequency, location and the team providing care. Home health care services are brought to patients who require intermittent skilled nursing, physical therapy, speech-language pathology or continued occupational services. Home health care is documented through progress reports for the patient’s doctor.
Although there are many differences between hospice care and home health care, both types of care can help older adults “age in place” in their homes. Ask your health care provider if home health or hospice care is an option for you. With hospice, the goal is to achieve comfort and have the best quality of life through the end of life.
Hospice services may also provide support to family members in addition to the patient. Hospice care is specialized medical care for people with a limited life expectancy, typically less than six months. Hospice focuses on comfort and quality of life instead of curative treatment.
Certified Nursing Assistant—Under the direction of our nurses, our certified nursing assistants are available to visit you and provide aide services which may include bathing or grooming. Aides are also available to assist you with additional services which can encompass light house cleaning and cooking. Social workers connect patients and families to resources such as adult daycare, aging services, medical equipment, and more. Both are generally covered by insurance if you meet the criteria. Both hospice and home health care are medical support services, even though different philosophies guide them.
For home health, the nurse will determine whether the patient is an appropriate candidate for home health nursing and therapies. In some cases, the patient may require more medical assistance than home health can safely offer. Or the patient might have such severe cognitive impairment that home health is not a viable option due to confusion, aggression, and significant memory problems. One of the more challenging situations family caregivers must face is when a loved one starts to decline.
However, studies show that pain and symptom management is more effective when delivered earlier in the disease process. Fully covered by Medicare, Medicaid, and most private insurance plans and HMOs, hospice is more about living than dying. That’s because it is meant to provide the best quality of life possible for patients whose prognosis leads doctors to believe they will not live past six months.
However family caregivers of a patient receiving treatment from these resources receive training education to enhance patient rehabilitation. Essentially, palliative care is a form of specialized medical care for people with serious illness, with the focus on providing relief from the symptoms and stress of a serious illness, according to Get Palliative Care. The goal is to enhance quality of life for both the patient and the family, with care provided by a specially-trained team of doctors, nurses and other specialists who work in conjunction with the patient’s existing doctors. Anyone at any age and at any stage in a serious illness can turn to palliative care along with curative treatment.
Hospice vs. Home Health and Care For Your Loved One
Home health care cannot be given to patients in a long-term care facility. Whether you are a patient, family member or caregiver, it is important to understand what the similarities and differences are between home health and hospice. We proudly offer the Omaha region’s largest continuum of senior living and health care services. Joyce Famakinwa is a Chicago area native who cut her teeth as a journalist and writer covering the worker’s compensation industry and creating branded content for tech companies and startups.
A medical director is an overseeing physician who usually specializes in geriatric or palliative care. Although though there is much information available about the benefits of hospice care, many misconceptions still exist which could keep you from seeking hospice care early. This series aims to debunk these myths and provide an accurate picture of how hospice adds life to days. I used them as a resource during my time in elder care, and everyone from their physicians to their social workers to their chaplain to their nurses were outstanding with great bedside manner.
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