Center to Advance Palliative Care

Since general inpatient services (GIP) are a designated level of care for Medicare-certified hospices, eligibility criteria for this level of care is spelled out by the federal language describing the Medicare Hospice Benefit (MHB). Given this, any language you or your hospital develop should be consistent with MHB requirements.

In order for the hospice to provide GIP in your hospital, there must be a written contract between the two entities (the hospice and the hospital). While it is not possible to anticipate all patient conditions and associated lengths of stay, the federal language makes it clear that the intent of GIP is for stays of short duration. To enforce this expecation, Medicare requires that each hospice provide at least 80% of its patients days as home care days. It may also be helpful to share with your management that NHPCO statistics reveal that more than 95% of hospice patient care days in 2007 were at the routine home care level and just over 3% of hospice patient care days were at the GIP level of care.

There is a sample hospital-hospice contract on the CAPC website that may be useful to you: go to www.capc.org and then insert 'hospital-hospice contract' in the search bar. Since each State has its own regulations governing health care providers, you will want to have the contract reviewed by a health attorney familiar with local rules.

Amber B. Jones
CAPC Hospice Liaison Consultant