Take Me To Post Comment Form Hospice is often viewed as a place to go, rather than a philosophy of care centered on the concepts of dignity, patient choice, family togetherness, compassion and quality of life. It would surprise many to know that over 90% of all hospice care is done in the home setting, with the patient and family in their familiar surroundings. Hospice inpatient facilities are becoming more prevalent around the Country. Inpatient facilities are designed to be home like and family friendly and most implement staffing patterns that facilitate more one on one care than can be offered in hospitals or nursing homes. However, misconceptions are common about the purpose and role of hospice inpatient care. Each hospice organization must follow the Hospice Rules and Regulations of the State of Georgia as well as the Hospice Medicare Conditions of Participation. Both outline criteria for two levels of Hospice Inpatient Care.
The “Inpatient Respite Level of Care was designed to give the family of the hospice home care patient an opportunity to take a break from care-giving responsibilities. Medicare guidelines allow patients five consecutive days of Respite Care. A patient is allowed to return multiple times if necessary when such needs can be justified. Inpatient Respite Care has proven to be a much needed and appreciated service.

The “General Inpatient Level of Care (GIP) exists for situations when a patient requires intensive management of acute symptoms such as pain, or when the patient’s condition calls for a level of care that cannot be performed in the home or nursing home setting. GIP care is also allowed when death is near and circumstances of the family are not conducive to keeping their loved one home. It was assumed by Medicare that GIP cases would be rare and for brief periods of time. Therefore, guidelines define this level of care as being “short term. GIP care can be offered in a hospital, a skilled nursing home or in a Hospice Inpatient Facility.

This may seem very straight forward. However, more and more people greatly desire inpatient hospice care. This desire is primarily related to the social and medical changes that have occurred over time which greatly impact one’s ability to be cared for at home by their family. For example, stay at home caregivers are the exception rather than the rule in our society today or the caregiver is often an elderly spouse. Also, hospitals are discharging patients who are much sicker than in the early years of hospice. In spite of this, each situation must be evaluated against the strict guidelines created by the Center for Medicare and Medicaid Services. During 2007, 275 individuals were cared for in our Inpatient Center. Of these patients, 160 arrived for end of life care while the others were stabilized and then transferred to home or to their nursing home. Most patients desire to remain at home under Hospice Care until their death. For others needing additional care, inpatient care is often a much appreciated and essential alternative to patients and their families.