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1`7 <br />Transitional Care Discussion Circle <br />Following the. introductions of the panel members, the discussion began with a <br />question regarding the provision end-of-life care at nursing homes as it is done in <br />hospice care. In response, panelist Betty Stevens of Brookshire Nursing Home <br />described the home's commitment to quality care for their residents. Their <br />facility includes the best and most comfortable care possible at the end of life for <br />patients by notifying the hospice, family members, and /or local churches. <br />However, she also recognized the limitations of serving primarily Medicare <br />recipients. As Medicare does not fully cover the cost of service for each patient, <br />the facility loses money by taking in Medicare patients. She recommended an <br />increase in the Medicare allowance in order to cover more of the patients' cost nt <br />each facility. <br />Diane Kapel and Janet Hadar, both employees of <br />UNC Hospital, indicated that the Hospital would not <br />turn away anyone without healthcare insurance <br />because it is a state hospital. They expressed the <br />need for the state to increase the benefits to cover <br />more of the cost of patient care. Kapel shared that <br />her staff meets with each patient and makes the <br />necessary arrangements for patients who live alone <br />and for those who may need transportation or in- <br />home services. Unfortunately, the hospital is seeing <br />a growing number of patients that do not have <br />additional support outside of the immediate services <br />of the hospital. Some patients may be allowed to <br />stay a day longer in the hospital in order to be able to care for themselves <br />independently once being discharged from the hospital. Hadar, a discharge <br />planner, indicated that there is a need for the patients to have some type of <br />transitional care from the hospital to their home as there is a lapse in care for <br />many patients once they leave the hospital. <br />Vibeke Talley, an occupational therapist and member of the Orange County <br />Department on Aging (OCDOA), visits patients' homes to assess the patient's needs <br />in order to provide quality in-home care. Once patients have contacted the <br />department and requested assistance with at-home rehabilitation, OCDOA uses a <br />Page 14 of 18 <br />