Inpatient Care

Inpatient Care Information
Criteria for Lake Superior Hospice’s "Home Away from Home" Suite

“Respite Care” Verses “Inpatient Acute Care” Criteria

Respite care, as defined by Medicare, is for caregiver relief. Respite care may be used for up to five days during each certification period (the time spent under Hospice Care). Certification periods consist of 90 days, 90 days, and then every 60 days. Daily physician visits are NOT required during respite care, and transportation to and from the hospice respite suite is the responsibility of the patient/family.

In-Patient acute care, as defined by Medicare, is for patient relief of symptoms, pain, psychological, sociological, or spiritual needs that cannot be managed in the patient’s home. Acute care may be used at any time during the patient hospice certification periods. The number of acute care days provided is dependent on the reasons for admission, however, the maximum number of acute care days provided under the actively dying phase is fourteen. Extensions can be made for a day or two if there is a prolonged imminent death. Once the patient’s symptoms are relieved, the patient is to return home. If a patient in acute care appears to be living beyond the fourteen days of the actively dying phase, without the ability to return home, he/she shall be placed in the first available skilled nursing home facility bed giving consideration to patient’s preference as able. For all other symptom management admissions, evaluation of continued acute care needs are made on a daily basis, and therefore, daily physician visits are required during inpatient acute care stays. Hospice may be responsible to secure and pay for transportation to and from the hospice suite for patient admissions to acute care from their home setting. Evaluation will be done for each individual case.

If a doctor wants his/her patient admitted to hospice suite, an evaluation will need to be done by a hospice RN to make sure the patient meets the criteria. If a doctor is considering discharging a hospital patient and admitting them to the hospice suite under acute care, the anticipation should be that the patient should live longer than 24 hours, and less than 14 days. If the patient is imminently dying (i.e. no urine output, dyspnea) they should not be transferred over to meet a whole new staff for that short period of time.