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CAPC Palliative Care Discussion Forum
Palliative Care in Nursing Homes

In Reply To: Re:Nursing home palliative care
Next Reply: Re:Re:Re:Nursing home palliative care
Next Message: Re:Re:Nursing home palliative care

Post Re:Re:Nursing home palliative care
Author: slmare
Date: Sep 16, 2007 5:19 pm

I am assuming you bill for your professional services, is that correct? Also, do the LTC facilities have their own hospices? We have been trying (only minimally successfully) to branch into the LTC arena. The vast majority of the LTCs in our vicinity also run their own hospices. Thus, they feel we will be taking "business" away from them. We are also associated with a hospice program. Any ideas on how we can overcome this barrier?

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+ Re:Re:Re:Nursing home palliative care (by AmberBJones on 09/18/2007)
There are several advantages to the nursing home for having partnerships with both palliative care programs and with hospices. The most important benefit realized from offering palliative care services in this setting is that patients, families and staff gain early access to specialized expertise - to complement the services offered by the nursing home staff - who are often stretched beyond capacity. Further, palliative care services can help to fill the gap for those patients who are ineligible for or do not chose hospice. As is true in other settings, an established palliative care service can assume a key role facilitating appropriate transitions to hospice by encouraging and supporting patient and family discussions about advanced illness care preferences and by providing accurate information about the benefits of hospice care. A secondary advantage gained by offering palliative care consultative services in the nursing home is financial. The palliative care team can provide and bill for specialized services (e.g. pain management and symptom control) while the nursing home is reimbursed under the Medicare Part A Skilled Benefit. This outreach is NOT in competition with hospice because a patient whose nursing home services are billed under Medicare Part A is ineligible for hospice care (two Part A providers cannot simultaneously provide services the same patient).

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