Casey House in Baltimore: In-Home Hospice with Medical Staff on Call

Casey House is a Baltimore-based nonprofit hospice agency providing palliative and end-of-life care in patients' homes, with a medical director, nursing staff, and social workers available 24/7. It serves the Baltimore metro area and operates as an independent provider rather than a facility-based operation, meaning families remain in their own space while clinical oversight and equipment arrive on site. For families preferring to avoid institutional settings during a patient's final months, Casey House functions as the primary care coordinator and oversees symptom management, pain control, and family support.

What Casey House Actually Is

Casey House is a Medicare-certified, state-licensed home hospice agency. Unlike a hospice residence or inpatient facility, it does not house patients. Instead, clinicians visit regularly and respond to urgent needs 24 hours a day. The organization is family-led, founded and governed by individuals who used hospice services and shaped the model around what they learned from that experience. It employs physicians, registered nurses, social workers, and chaplains, and contracts with vendors for medical equipment and pharmacy services. The agency operates across Baltimore City and Baltimore County, southern Maryland, and parts of Anne Arundel County.

The distinction matters: families must arrange a location (home, assisted living facility, or family member's house), but Casey House manages medical coordination and comfort care. If a patient is already in an assisted living or memory care setting, Casey House coordinates with that facility's staff. If the patient is homebound in a private residence, visiting nurses manage medication and symptom assessment in person.

Services and Typical Cost Range

Casey House covers the core hospice services Medicare requires: physician oversight, nursing visits (frequency based on patient condition), social work, chaplaincy, counseling, aide services, medication, and medical equipment rental. Frequency of nursing visits ranges from once weekly to daily, depending on the patient's stability and family requests.

Hospice care is primarily paid through Medicare Part A, Medicaid, or private insurance, rather than out-of-pocket fees. Patients eligible for Medicare (age 65 and older, or younger with ESRD or certain disabilities) automatically access hospice benefits with no separate premium. Medicaid covers hospice in Maryland without cost to eligible enrollees. Veterans may qualify for additional benefits through the VA.

Families should verify directly with Casey House whether their insurance is accepted and what the copay structure is; Medicare hospice typically involves minimal cost to the patient or family. Confirm whether specific medications or equipment suppliers fall within Casey House's network, as some specialized items may trigger out-of-pocket expense.

How Casey House Compares to Other Baltimore Hospice Providers

Baltimore and the surrounding region have several Medicare-certified hospice agencies. Gilchrist Hospice, part of the Johns Hopkins Health System, is the largest in the region, with inpatient residences as well as home visits; it offers more facility-based options if a patient cannot remain at home. Evergreen Hospice and Cornerstone Hospice are also active in Baltimore County and the metro area. Gilchrist and Evergreen offer both home and inpatient stays, whereas Casey House is exclusively home-based.

Choose Casey House if the family is committed to in-home care and values a smaller, nonprofit structure with fewer institutional layers. Choose Gilchrist if the patient may need inpatient respite, short-term symptom crisis management in a dedicated facility, or if the family is already integrated into Johns Hopkins care. Choose Evergreen if the patient is in a rural area of Baltimore County or Howard County where Evergreen has stronger logistics.

All three are Medicare-certified and provide 24/7 support. The real difference is geography, scale, and care setting. Casey House's limitation is that it has no backup inpatient beds if home care becomes unmanageable; families would need to use another provider's inpatient services, though Casey House can coordinate.

Who Casey House Suits and Who It Does Not

Casey House suits families with a patient who can remain at home or in a residential community, whose caregivers (family members or hired aides) are available day-to-day, and who want continuous but non-institutional care. It also works when the patient is already living in assisted living or memory care; Casey House works alongside facility staff. Many patients thrive in this model during the final weeks, with familiar surroundings and flexible family visitation.

It does not suit patients without adequate home-based support. If a patient lives alone and family cannot arrange paid caregiving between Casey House nursing visits, home hospice becomes very difficult. It also does not work if the patient requires inpatient crisis management for severe pain or restlessness that cannot be controlled at home; Casey House would then refer to an inpatient hospice or hospital.

What the First Referral and Intake Involve

A patient becomes eligible for hospice when a physician and Casey House's medical director both confirm that the expected prognosis is six months or less. The referral typically comes from the patient's current doctor, a hospital discharge planner, or an assisted living facility care coordinator. The family calls Casey House directly or receives a referral contact.

Initial paperwork includes a financial and insurance verification, HIPAA consent, and a detailed symptom and preference assessment with a nurse and social worker. The agency's clinical team reviews the patient's diagnosis, current medications, pain level, and goals. If the patient is cognitively clear, they participate. If not, the primary caregiver or healthcare proxy leads the conversation. A physician or nurse practitioner visits within 24 to 48 hours, sets up a medication plan (often shifting away from curative drugs toward comfort-focused options), and arranges the first routine visit schedule. Equipment orders (hospital bed, oxygen, medications) are placed immediately.

Hours, Access, and Logistics

Casey House provides 24/7 on-call nursing response, not staffed offices. Regular visiting hours are set per patient (often weekday mornings and afternoons, with on-call coverage nights and weekends), but the on-call nurse responds to urgent symptoms or family questions anytime. Families reach the nurse line by phone.

The agency operates only in homes or facilities already arranged by the family; there is no centralized location to visit. Initial intake often happens by phone and home visit. Parking and location logistics depend entirely on whether care is in the patient's home, a family member's home, or an assisted living building.

Confirm current service areas and exact response times with Casey House directly; geographic reach may shift, and some outlying county areas may have longer response windows than Baltimore City.

Why Casey House Matters in Baltimore

For families trying to manage end-of-life care without hospital transfers or facility admission, Casey House provides a proven nonprofit structure that keeps patients in their chosen setting while ensuring medical supervision and 24-hour support.