Many people believe that hospice care is only available for a terminally ill person living at home or in a hospice in-patient facility. But hospice is also available for nursing home residents. A doctor must be the one to determine if someone is eligible for hospice care.

Once a doctor has certified that a person in a nursing home is eligible to be enrolled in hospice care, the hospice becomes responsible for providing and overseeing that person’s care in the nursing home.

By law, the nursing facility is considered the person’s "home” and the hospice must provide care equivalent to what the person would receive in their own home or in a hospice in-patient facility.

This type of hospice care is covered under Medicare. There are virtually no co-pays for medications, equipment, or specialized medical care.

This includes:

1. Ensuring that the nursing home staff provides care according to a detailed "hospice care plan” that hospice sets up with the nursing home administrators. 2. Making sure that all nursing home staff provide hospice-level care rather than care that just meets routine nursing home standards.

3. Monitoring the nursing home to ensure that all the patient’s needs are being met and all their hospice-related rights are being protected.

4. Providing hospice staff in the nursing home, including physicians, nurses and aides, to provide care in any crisis that is beyond the nursing home capabilities.

5. Providing hospice-level care until the crisis is resolved. This can mean anything from increased frequency of hospice staff visits to round-the- clock care by hospice staff in the nursing home. It can also include transfer to a better equipped medical facility.

There have been instances when nursing homes have resisted a family’s desire to have their loved one enrolled in hospice care for some reason.

If this happens, the family’s best approach is not to argue with the nursing home but to talk directly with the patient’s doctor. If the doctor orders the person admitted to hospice care, then by law hospice takes over and the patient will receive the 100% of the hospice-level care they need.