Hello Jimmie:

I  have always been intrigued with working in hospice. Before OT school,
I was a hospice patient family volunteer. While in grad school, I gave a
presentation  to  our  local  hospice  on  "The  Role of OT in Hospice".
Several  years  after  graduating,  I  had an opportunity to work with a
hospice  that  was JUST starting to develop a therapy department. It was
great  because the hospice hired a PT consultant to put things together.
This  PT was great (she had been around a long time). For a while, I was
seeing  an  occasional  hospice patient. But then, financial reality hit
the  hospice leadership and they pulled the plug on everything! All this
is just to give a little background on my hospice experience.

On  to  your  questions/statements. You are correct that hospice is paid
per  diem.  For this payment, they are expected to provide all necessary
care for their patient. Should an OT be called in, the hospice pays that
therapist  from  this  per  diem  payment.  Thus you are 100% correct in
assuming  that little incentive exists to provide OT or PT services. Not
that it doesn't happen, but from my experience, it happens only rarely.

Other  than  the reimbursement issue, OT and hospice fit like a glove. I
always hoped that I would work with dying patients, but I've since given
up hope because hospice just won't pay for therapy services, except in a
few extreme cases. At least, that's my experience.

Ron

===============<Original Message>===============

On 3/31/2005, Jimmie Arceneaux <[EMAIL PROTECTED]> said:


JA> Question:

JA> This is directed specifically to U.S. OTs, but others may
JA> provide information relative to their particular practice area.  I
JA> have never worked in hospice care before, but I just read an
JA> article about OT in hospice care.  I understand the
JA> philosophical basis of OT with patients that would meet hospice
JA> criteria, but I am wondering how an OT would gain access to
JA> hospice patients.  It is my understanding, although I may be
JA> wrong, that hospice is a bundled, prospective payment, under
JA> Medicare.  It would seem under that type of system that it
JA> would be difficult to convince the powers that be of adding a
JA> non-typical service (i.e. as it would affect there bottom
JA> line).  Is anyone currently on the list providing service to
JA> hospice patients?  If so, please provide information on the
JA> referral process and plan of care process.

JA> Thanks,

JA> Jimmie Arceneaux, LOTR
JA> Metro Preferred Home Care
JA> 3501 N. Causeway Blvd., Ste 200
JA> Metairie, LA 70002
JA> 504-838-7080
JA> Fax 504-833-9309



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