During an end-of-life journey, a patient may have uncontrolled symptoms that cannot be managed in their home or facility. Care in a AccentCare inpatient center (IPC) allows eligible patients to come to a location where they can receive around-the-clock care from hospice professionals. Typically, patients stay for a short period of time (from hours to days) until their symptoms are brought under control. Because hospice care supports both patients and families, patients may also come and stay at an inpatient center for a set amount of time while their at-home caregiver takes some time to recharge.
AccentCare operates our own inpatient centers in select locations. We also provide inpatient care through our partnership with many hospitals and skilled care facilities in our communities, so no matter where you are this care is available to you.
Our Inpatient Centers
Our centers are designed with the comfort of patients and families in mind, and families may spend unlimited time with their family members (restrictions due to COVID-19 may apply). This is an important time for caregivers to be with their loved one, and we provide a kitchen, family space, WiFi, and other amenities for the use of families, including areas meant specifically forchildren.
Diagnosis, Care Team and Stay
Our focus is on the patient and family and their individual needs. AccentCare’ highly skilled interdisciplinary care team is present at the IPC: doctors, nurses, social workers, certified nursing assistants, therapists, chaplains, volunteers, and a music therapist.
A patient may qualify for a short-term stay at an IPC for several reasons, including uncontrolled pain, decreased blood pressure, decreased urine output, intractable nausea, vomiting and/or diarrhea, respiratory distress, decubiti or other complex skin lesions/wounds, other symptoms that are unmanageable at home (active seizures, active bleeding, etc.), need for respite care (up to 5 days), and if there are unmet skilled needs in the patient’s home because the family is not able to provide these skilled needs. Physicians who would like to apply for and receive hospital privileges may care for their patient at any time. They continue to bill under Medicare Part B.
The number of days the patient may stay at the IPC for inpatient level is based upon the need for an unmet skilled need/symptom management. A plan will be developed to address discharge planning once symptoms are controlled and the caregivers will be included in this discharge plan. The average number of days a patient is at a IPC is 5-7 days.
Discharge from the Inpatient Center
Our IPC staff work closely with the patients and families to assist them with discharge planning. The hospice team will continue to care for patients and families when they leave the IPC while the patient remains on the hospice program. If any new uncontrolled symptoms develop, the hospice team will coordinate a return to the IPC as appropriate.
Common Questions
Who is Eligible for Inpatient Hospice?
A variety of hard-to-manage symptoms may indicate that a patient is eligible.
- Sudden deterioration that requires intensive nursing intervention
- Uncontrolled pain
- Uncontrolled nausea and vomiting
- Pathological fractures
- Unmanageable respiratory distress
- Symptom relief via intravenous medications that require close monitoring
- Wound care that requires complex and/or frequent dressing changes that cannot be managed in the patient’s residence
- Unmanageable agitation; delirium; or acute severe anxiety
- Uncontrolled seizures
What Are the Levels of Care
Routine Home Care
Provided by hospice team members who visit the patient and their family in their home, wherever that may be.
Continuous Care
Through constant care, nurses and certified nursing assistants provide support in the home or facility to help manage and ease out-of-control symptoms.
General Inpatient Care
Provided at one of our inpatient centers or in a hospital or skilled nursing facility for patients who have uncontrolled pain or symptoms that can’t be managed in another setting.
Inpatient Respite
Care Up to 5 days of care at one of our inpatient centers or a contracted facility to give the family or caregiver a rest.
Questions to Ask Your Care Team
What to ask while your loved one is on general inpatient level of care?
- Who is the doctor in charge?
- What new medications or interventions have been tried and how well have they worked (or not)?
- How will we communicate about changes in my loved one’s condition?
- What can I do to be prepared for my loved one to return home?
- Discharge planning/discussions from the inpatient setting start on Day 1. What does this mean for my loved one?
What to ask prior to location transfer:
- What is the symptom(s) we are trying to manage?
- What new medications or interventions will be tried?
- What can/should I bring with me?
- Who can visit/stay with me/my loved one?
- Will my current hospice team care for me/my loved one?
- How long could my loved one be away from home?
Who Pays for Inpatient Hopsice?
100% of costs to stay at an IPC are paid by Medicare/ Medicaid and most insurance companies for a qualifying short-term stay. When a patient no longer meets the requirements to stay at an IPC, but they and/or the family want to extend the stay, and they have the means to pay, then a private pay rate may be negotiated with the IPC.
Hospice will pay for transportation to and from home and the IPC. Also, medical equipment, medical supplies and medications related to the patient’s diagnosis are covered and provided for the patient during the qualifying stay.
Four Levels of Hospice Care
The levels of hospice care are meant to help patients achieve their goals of care at different points in their journey.
Not all patients require the same level of care.The appropriate level of hospice care is based on the patient’s specific needs and clinical eligibility, established through the patient, family, hospice physician and attending physician collaboration. Patients may qualify for higher levels of care for certain lengths of time depending on medical needs.
Inpatient Care
Length of Stay
Short-term | average length of stay is hours to days
Location
Nursing home, hospital, or hospice inpatient center (IPC)
Reasons
Patient is having uncontrolled symptoms (i.e. pain, respiratory distress, vomiting, bleeding)
Transfers
Physician determines when patient is stable for transfer, and hospice social worker coordinates transfer to a home, assisted living facility, or nursing home ( i.e. Routine Hospice with family)
Continuous Care
Provided by hospice team members who visit the patient and their family in their home, wherever that may be.
Through constant care, nurses and certified nursing assistants provide support in the home or facility to help manage and ease out-of-control symptoms.
Routine Care
Provided by hospice team members who visit the patient and their family in their home, wherever that may be.
Respite Care
Up to five days of care at one of our inpatient hospice centers or a contracted facility to give the family or caregiver a rest.
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