Center to Advance Palliative Care

Libby, from a financial standpoint, this decision to "flip" an ICU bed to a hospice bed certainly doesn't seem to make sense. (Not to mention the issue of tying up an ICU bed if they need it for another pt requiring ICU level care and ICU nurses having to switch gears 180 degrees that may be difficult for them (beyond terminal wean and comfort/palliative care until transfer to palliative care bed/general med bed for example). Frankly, a LOT of money would likely be lost (based on inpatient hospice reimbursement only (current FY '09 medicare reimbursement rate of $622 per day for inpatient hospice)). Even though some money would probably still be lost, it would make more sense to have a few general medicine floor beds designated as "swing beds" (if that is possible - we are currently evaluating the logistics and costs involved in potentially doing so at our institution.....we did so a while back ago and regulations governing inpatient hospice were prohibitive in achieving this goal). Our primary impetus for trying to create some inpatient hospice swing beds in our institution is the suffering that our patients (and particularly their families) often go through when we are forced to move them from our institution to an inpatient hospice floor at another facility nearby. Hope this helps.