Does Hospice Pay for Nursing Home?

Ana Safarian • August 6, 2025

If you’re helping care for a loved one nearing the end of life, you’re probably thinking about the kind of support they will need, and what care might cost. One of the most common and confusing questions that comes up is: Does hospice pay for nursing home care?


It’s easy to see why many families ask. While hospice and nursing home care are often provided at the same time, they are two different services. Each one has its own goal and billing process. 


This article explains how payment works when someone receives hospice care inside a nursing home. It will also help families understand what is and isn’t covered, and how to prepare for the nursing home and hospice costs involved.


What Hospice Covers


Hospice care provides services for people with a terminal illness who have chosen comfort-focused support instead of treatment to cure their condition. Its goal is to improve their quality of life by managing pain symptoms, reducing stress, and supporting the patient and their family. Hospice services typically include:


  • Nurse visits 
  • Medications related to the terminal illness 
  • Durable medical equipment 
  • Emotional and spiritual support
  • Social work services 


These services follow the patient wherever they live. If someone is living in a nursing home, the hospice team will visit them there and coordinate with the facility staff to give them care. This is how hospice and nursing home coverage work together to support the patient and their family. 


What Hospice Does Not Cover in a Nursing Home 


Hospice care includes important services for your loved one, but it does not pay for room and board in a nursing home. That part is usually handled and billed by the facility itself. 


Many families assume that once they start hospice, everything is covered. But, even with hospice involved, the nursing home will continue charging for your cost of staying in the facility, including housing, meals, and daily assistance. Hospice provides care related to your loved one’s illness, but the nursing home is the one that handles basic living support. 


This shared setup for the payment is how it is commonly done. It’s important to know that hospice services in nursing homes do not include coverage for the actual cost of staying there. 


Who Pays for Nursing Home Costs During Hospice?


Because hospice doesn’t cover the cost of staying in a nursing facility, families often ask: Who pays for a nursing home in hospice? Does hospice pay for nursing homes? The answers to these questions depend on their insurance, income, and the type of care they want for their loved one. 


Medicaid 


Medicaid often pays for room and board in a nursing home, even if hospice has already started. To qualify for Nursing Home Medicaid coverage, most states require single applicants to have at most $2,000 in countable assets, while married couples are usually allowed up to $3,000 or $4,000, depending on state rules. Once approved, Medicaid will continue to pay for the facility stay. 


Private Pay 


If the patient does not qualify for Medicaid and doesn’t have health insurance that covers long-term care, families usually have to pay out of pocket. According to the American Council on Aging and SeniorLiving.org, monthly nursing home costs can range anywhere from $9,277 to $10,965 or more, depending on the location, provider, and level of care. 


Long-Term Care Insurance 


Some long-term care policies may help cover your loved one’s room and board during hospice. The coverage varies by policy, and it’s best to directly contact the insurance provider to confirm the benefits of your plan. 


Many families are often confused about Medicare hospice and nursing home benefits.
Medicare usually includes most hospice services at no cost, though you may owe up to $5 for prescription drugs for pain and symptom management. However, it does not cover room and board in a nursing facility unless the patient is receiving skilled rehabilitation, which is different from hospice. 


Skilled rehabilitation is a short-term medical treatment or therapy after a hospital stay, aiming to help the patient recover, regain strength, or improve their movement. It differs from hospice, which is intended to provide comfort rather than restore health. In these cases,
Medicare covers room and board because during the time the patient is receiving daily care meant to help them improve.


How Hospice and Nursing Homes Work Together


When a person is living in a nursing home and receives hospice care, both health teams play a role. At Olympia Hospice, we work closely with the nursing home staff to keep care coordinated and clear. 


The nursing home team usually handles daily living support like meals, bathing, and safety. Meanwhile, our team provides symptom management, medication, and emotional or spiritual support services. In hospice services in nursing home settings, collaboration is essential to ensuring patient comfort. 


Questions to Ask When Hospice Care is Provided in a Nursing Home

Before starting hospice care in a nursing home, it’s helpful to ask a few direct questions. This makes sure everyone understands hospice and nursing home coverage, and who handles each part of care for their loved one. 


Here are some important questions to ask: 


  • Will the nursing home bill separately from hospice?
  • What services are covered by hospice and what are not?
  • Can my loved one keep their current room and caregiver?
  • Who do I call for emergencies, the nursing home or the hospice team?


Having answers to these questions early can help prevent confusion in the future. It also gives families a better understanding of how to prepare for nursing home and hospice costs. 


Final Thoughts on Coverage


End-of-life care often brings financial stress to the families involved. Planning ahead and asking the right questions early on can make a difficult process a little more manageable. 


Does hospice pay for nursing home care? The short answer is no, not completely. Hospice pays for medical support, symptom management, and emotional care, but the nursing facility charges separately for room and board. This applies even under Medicare hospice nursing home benefits. Medicare does not cover the facility stay unless the patient is receiving skilled rehabilitation, which is different from hospice care. 


We take time to explain these financial details before your care begins. Families are given a clear breakdown of what hospice provides and what nursing facilities handle. This way, families can focus on caring for their loved one and avoid the confusion. 


Make Care Decisions with Confidence 


For families considering hospice in a nursing home, it’s important to understand how care is provided, who pays for a nursing home in hospice, and what coverage includes or excludes. 


At
Olympia Hospice Care, we work closely with nursing home staff to provide personalized, consistent care focused on your loved one’s comfort. Our team is here to explain your options, walk you through how hospice works in nursing facilities, and help you make informed choices with confidence. 


Contact us today to schedule a consultation
. We’re here to walk you through the steps and provide care that prioritizes your comfort, dignity, and peace of mind. 

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When a loved one is approaching the end of life, it's quite a common struggle to see that they are unable to digest food or hydrate themselves with water anymore. And so IV fluids, or intravenous hydration, are often done to replenish this and provide them the comfort they need. The choice to do them is usually made on a case-by-case basis. Factors such as the patient’s overall condition, goals of care, and quality of life come into play. This leads many to ask: does hospice give IV fluids at home? Well, the answer depends on several key considerations, including the patient’s needs, the hospice provider’s approach, and what ultimately aligns with comfort-focused care. In this guide, we’ll explore when and why IV fluids might be given at home during hospice, what alternatives exist, and how hydration is thoughtfully managed at the end of life. Do Hospice Patients Get IV Fluids? In hospice care, the main goal is to keep the patient as comfortable as possible, not to cure illness or extend life at all costs. Because of that, treatments like IV fluids are not always used. Instead of focusing on medical procedures, hospice teams focus on easing pain, shortness of breath, and other symptoms that may come up near the end of life. Should You Give IV Fluids at End of Life? Choosing to give IV fluids at the end of life involves both medical reasoning and personal values. There have been discussions, new and old, regarding the ethics of providing water and needed calories to dying patients to sustain them even amidst this difficult period. Some families see fluids as a way to provide comfort or maintain a sense of care. Others may feel unsure about stopping them, especially when emotions are running high. If they are unable to communicate, families and care teams work together to make thoughtful choices that support comfort, peace, and dignity during the final stage of life. But if you're looking for a sound and medical reason for this question, the decision often comes down to what the patient seems to need at the moment. As the body nears its end , its natural functions begin to slow. This includes how it handles food, water, and fluids it basically needs less of these things as it transitions towards death. At this stage, the body often no longer needs or benefits from the same kind of hydration it once did. There has also been a 2023 study about fluid resuscitation that highlighted how large amounts of IV fluids can potentially cause electrolyte imbalance and hypervolemia (fluid or volume overload). Overhydration can lead to further organ dysfunction and would just worsen the state of the already-suffering patient. So, with all that being said, giving a hospice patient IV fluids won't really do any much help as their organs don't function properly anymore, and the liquid passed won't be turned into urine. Giving the patient fluids may sound like an empathetic decision, but truthfully, it just does more damage than good. Remember, hospice care focuses on reducing anything that might add stress to the body, especially if it doesn’t improve how the patient feels. Instead of using treatments like IV fluids that may place extra strain on the body, hospice teams shift their focus to comfort, using methods that are gentle and supportive. For families asking, does hospice give IV fluids at home , do understand that stopping fluids is not meant to cause harm. It’s often part of a thoughtful plan to avoid unnecessary interventions as the body prepares to rest. How Long Can a Hospice Patient Survive Without Fluids? The amount of time a person can live without fluids during hospice care depends on several factors, including their overall condition, illness, and how far along they are in the dying process. For some, it may be just a few days. For others, it could be a week or slightly longer. For instance, in 2003, a survey was implemented among hospice nurses in the Oregon area to draw substantial conclusions from the situations of their patients who opted to pursue food and fluid refusal to hasten the process of their passing. A good 85% of the patients died within 15 days of stopping food and water intake. At this point in their life, if there is no fluid or food added anymore, comfort is just the highest priority. So, Can Patients Have IV Fluids at Home? In some cases, yes, patients can receive IV fluids at home while under hospice care. However, this is not always offered by default. Each hospice program has its own policies, and decisions are guided by the care plan, patient needs, and what’s safe to manage in a home setting. If IV fluids are considered helpful, the hospice team will determine whether it’s possible to arrange the supplies, train caregivers, or assign a nurse to administer them. This usually happens only when fluids are expected to bring short-term relief without causing added discomfort. Families asking does hospice give IV fluids at home should speak directly with their hospice provider. Open communication helps clarify what’s available, what’s appropriate for the patient’s condition, and how best to support their comfort during this time. Who is Allowed to Administer an IV at Home? Administering IV fluids at home requires medical training. In most cases, a licensed nurse or hospice care provider is the one to place and manage the IV. This ensures the process is safe, sterile, and tailored to the patient’s needs. Some hospice programs may allow trained family members to assist with ongoing care after the IV is started, but this depends on the situation and local regulations. Safety protocols, such as infection control and proper monitoring, are essential whenever IV fluids are given at home. What Is the Alternative to IV Fluids at Home? When IV fluids are not used, there are simple ways to keep a patient comfortable without putting stress on the body. Hospice teams may suggest: Moistening the mouth with oral swabs dipped in water or a gentle mouthwash Offering ice chips to ease dryness, if the patient can safely handle them Providing small sips of water when swallowing is still possible Applying lip balm to prevent cracked or dry lips Using a cool mist humidifier to keep the air moist and reduce discomfort These methods don’t replace hydration but can relieve dry mouth and help the patient feel more at ease. How Do You Give Fluid to an End-of-Life Patient at Home? Providing gentle hydration at home starts with keeping the patient’s mouth and lips moist. A soft sponge or oral swab dipped in water can be used to moisten the inside of the mouth. If the person is alert and able to swallow, a spoonful of water or ice chips may be offered slowly and carefully. Always follow the guidance of the hospice team, as each patient’s needs and swallowing ability can vary. The focus is on comfort, not on meeting fluid intake goals. Small, thoughtful steps often provide more relief than larger medical interventions at this stage. Personalized Care, Thoughtful Guidance with Olympia Hospice  At Olympia Hospice Care , we understand that families often ask difficult questions when trying to make the best choices for their loved ones. These decisions can feel overwhelming, but you don’t have to navigate them alone. Our team is here to provide clear answers, compassionate support, and care that honors comfort, dignity, and peace. If you're considering hospice care at home and need guidance on hydration options or overall care planning, contact us today . We’re here to help you find the right path forward with confidence and care.
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