Tyler · Nursing facilities & skilled nursing
Hospice care in a nursing home, Tyler
Yes — hospice care comes into your family member's Tyler-area nursing facility, working alongside the facility's staff.Hospice covers the medical care; the room-and-board side stays on whatever payment plan it's already on.
01 —The 100-day cliff
What happens when Medicare's rehab benefit ends
Medicare's Part A skilled-nursing benefit covers up to 100 days of skilled care after a qualifying hospital stay. It ends when rehab stops making progress — and for many families, day 100 lands at exactly the moment their loved one is declining, not recovering.
Hospice often picks up at that transition. The SNF stay can continue (with the room-and-board side moving to private pay, LTC insurance, or Medicaid long-stay), and the Medicare Hospice Benefit covers the hospice medical services 100%. Two physicians certify hospice eligibility — six months or less if the illness runs its course — and the team starts the day after eligibility is confirmed.
If your family member is approaching day 100 and the SNF is preparing to discharge them, this is the moment to call. The 8-question hospice quiz is built for exactly this decision.
02 —Coordination
Four ways hospice and the SNF share care
01
MDS coordination from day one
Every nursing-facility resident has a Minimum Data Set (MDS) — the regulatory assessment that drives care planning and reimbursement. Our hospice team shares information with the SNF's MDS coordinator so the hospice care shows up where it should and the SNF's quality measures aren't affected by changes outside their control.
02
Medications through the SNF pharmacy, paid by hospice
Medications related to the terminal illness — pain, anxiety, breathlessness, nausea — are paid 100% by the Medicare Hospice Benefit, not by the family. They're typically still dispensed through the SNF's contracted pharmacy so the floor nurses can administer them as usual; we coordinate the billing on the back end.
03
Hospice aide vs SNF aide — they don't double up
Your family member already has CNAs from the SNF handling bathing, feeding, repositioning. The hospice aide doesn't repeat that work; she supplements it on specific days, especially when end-of-life care needs more hands-on time. The two teams know which days are theirs.
04
Physician of record stays the same
Most SNF residents have an attending physician (often the SNF's medical director or a primary-care doctor who rounds at the facility). That physician stays the attending. Our hospice medical director joins the team as the hospice physician — they co-sign the plan of care; the attending isn't replaced.
03 —The Tyler nursing-facility landscape
We serve residents wherever they already are
- Multiple skilled-nursing facilities clustered around Tyler's major hospitals (UT Health, CHRISTUS Mother Frances), plus stand-alone SNFs across South Tyler and the periphery
- Some Tyler assisted-living communities include licensed skilled-nursing units for residents whose needs progress
- Texas licenses these as either skilled-nursing facilities (SNF — Medicare/Medicaid certified for rehabilitation and skilled care) or nursing facilities (NF — typically Medicaid long-stay)
- We provide hospice care to residents in any Tyler-area SNF or NF — partnership is per-resident, not exclusive to a chain
If your family member is in an assisted-living community rather than a nursing facility, the workflow is similar but the regulatory layer is different.
04 —What about Medicaid?
Medicaid room-and-board + Medicare hospice — they don't conflict
Many long-stay nursing-facility residents are on Medicaid for the room-and-board side after the 100-day Medicare rehab benefit ends. Medicaid pays the SNF; the family typically contributes a share-of-cost based on income. Hospice doesn't change any of that.The Medicare Hospice Benefit pays for hospice services separately, on top of whatever's paying the SNF. The two programs coordinate at the back end so the family doesn't have to.
If you're still navigating the financial side, our social worker can walk you through what changes (and what doesn't) when hospice starts.
05 —Common questions
What SNF families ask first
Will the SNF charge us extra because Mom is on hospice?
No. Medicare pays the SNF for hospice patients at a hospice room-and-board rate when the patient is dually eligible for Medicaid; for private-pay or LTC-insurance residents the room-and-board bill keeps coming as it was. The hospice services themselves — nurses, medications related to the illness, aide, chaplain, social work — are paid 100% by the Medicare Hospice Benefit, not by the family or the SNF.
Does Mom have to give up her SNF doctor?
No. The SNF attending physician stays in place. The hospice medical director joins as a second physician of record (and co-signs the plan of care). The two doctors talk; the family doesn't have to coordinate them.
What happens at day 101? The 100-day Medicare rehab benefit is ending.
This is the most common moment families learn about hospice in a SNF. Medicare's Part A skilled-nursing benefit covers up to 100 days of skilled care following a qualifying hospital stay — and ends abruptly when rehab is no longer making progress. If your family member is approaching that cliff and their condition is declining (rather than rehabbing), hospice eligibility is often the right next step. Hospice changes who pays for the medical care; the SNF stay can continue, with the room-and-board side moving to private pay, LTC insurance, or Medicaid long-stay depending on the family's situation.
Who orders her medications and how does that work?
The hospice nurse, in coordination with the hospice medical director, writes the orders for hospice-related medications (pain, anxiety, comfort meds). The SNF pharmacy dispenses them; the SNF floor nurses administer them on the SNF's regular med-pass schedule. We pay; the SNF runs the route.
Will the SNF CNA stop visiting if hospice is involved?
No. The SNF CNAs continue exactly what they were doing — that's their job, and that's what the SNF bill is paying for. The hospice aide is additive, especially in the last days of life when more hands are useful. The two aides don't compete; they trade off based on what your family member needs.
Can we move Mom home from the SNF on hospice if we want to?
Yes. Many families do choose to bring their loved one home for the final stretch — often after hospice has stabilized symptoms enough that home becomes feasible. Hospice transitions with you: same nurse, same aide, same medical director, same coverage. We coordinate with the SNF on discharge and continue the care without interruption.
Accreditations & certifications
Medicare-Certified
CMS Provider · NPI #1700460789
Texas-Licensed
DSHS HCSSA #020708
CHAP Accredited
Independent accreditation
When the SNF says rehab is done, we begin.
A nurse can meet you at the SNF, coordinate with the floor team, and walk you through what hospice will look like for your loved one specifically. Day or night.
Serving Tyler and 8 East Texas counties · Free for Medicare-eligible patients · No paperwork to start