Frequently Asked Questions

WHO IS ELIGIBLE FOR HOSPICE SERVICES?

Hospice care is provided to terminally ill patients who have a limited life expectancy and who wish to receive comfort care rather than curative treatment for their illness.

WHO WILL PAY FOR HOSPICE SERVICES?

Medicare or Medi-Cal pay for hospice care. There is no out-of-pocket cost to patient/family under the Medicare / Medi-Cal hospice benefit. Most medical insurances and health maintenance organizations offer hospice care as a benefit.

WHO WILL BE INVOLVED IN PROVIDING HOSPICE SERVICES?

Hospice services are coordinated and delivered by a team of healthcare professionals of various disciplines, including physicians, registered nurses, social workers, home health aides, spiritual counselors, therapists, dietitians and volunteers. This team is known as the “interdisciplinary team.” The interdisciplinary team customizes a plan of care which aims to manage the patient’s pain and meet the patient’s and family’s needs

CAN MY FAMILY BE INVOLVED IN HOSPICE CARE?

Family members are encouraged to participate in the patient’s care as much as possible. Hospice views the patient and family as the unit of care.  If patient has no family members to assist in care giving, hospice will work with a caregiver or willing friends or neighbors of the patient.

CAN PRIMARY PHYSICIAN WORK WITH THE HOSPICE TEAM?

Yes. Most primary physicians continue to plan most of the patient’s care in coordination with the hospice team and the hospice physician.

WILL HOSPICE PROVIDE MEDICINES ?

Medications necessary for pain relief and symptom management related to the terminal illness are provided by hospice.

WILL HOSPICE PROVIDE MEDICAL SUPPLIES AND EQUIPMENT?

Medical supplies ( e.g. diapers, chux, gloves), and medical equipment (e.g. hospital bed, wheelchair, oxygen) necessary for pain relief and symptom management related to the terminal illness are provided by hospice.

CAN HOSPICE CARE BE DISCONTINUED?

A patient can discontinue hospice services at any time.

HOW DOES HOSPICE CARE BEGIN?

Typically, hospice care starts as soon as a formal request or a ‘referral’ is made by the patient’s doctor. Often a hospice program representative will make an effort to visit the patient within 48 hours of that referral, providing the visit meets the needs and schedule of the patient and family/primary caregiver. Usually, hospice care is ready to begin within a day or two of the referral. However, in urgent situations, hospice services may begin sooner.

IS HOSPICE AVAILABLE AFTER HOURS?

Hospice care is available ‘on-call’ after the administrative office has closed, seven days a week, 24 hours a day. Most hospices have nurses available to respond to a call for help within minutes, if necessary. Some hospice programs have chaplains and social workers on call as well. How does the hospice work to keep the patient comfortable? Many patients may have pain and other serious symptoms as illness progresses. Hospice staff receives special training to care for all types’ of physical and emotional symptoms that cause pain, discomfort, and distress. Because keeping the patient comfortable and pain-free is an important part of hospice care, many hospice programs have developed ways to measure how comfortable the patient is during the course of their stay in hospice. Hospice staff works with the patient’s physician to make sure that medication, therapies, and procedures are designed to achieve the goals outlined in the patient’s care plan. The care plan is reviewed frequently to make sure any changes and new goals are in the plan

Can a patient be cared for by hospice if he or she reside in a nursing facility or other type of long-term care facility?

Hospice services can be provided to a terminally ill person wherever they live. This means a patient living in a nursing facility or long-term care facility can receive specialized visits from hospice nurses, home health aides, chaplains, social workers, and volunteers, in addition to other care and services provided by the nursing facility. The hospice and the nursing home will have a written agreement in place in order for the hospice to serve residents of the facility

What happens if a patient cannot stay at home due to increasing care need and require a different place to stay during final phase of life?

A growing number of hospice programs have their own hospice facilities or have arrangements with freestanding hospice houses, hospitals or inpatient residential centers to care for patients who cannot stay where they usually live. These patients may require a different place to live during this phase of their life when they need extra care. However, care in these settings is not covered under the Medicare or Medicaid Hospice Benefit. It is best to find out, well before hospice may be needed, if insurance or any other payer covers this type of care or if patients/families will be responsible for payment.

Do state and federal reviewers inspect and evaluate hospices?

Yes. There are state licensure requirements that must be met by hospice programs in order for them to deliver care. In addition, hospices must comply with federal regulations in order to be approved for reimbursement under Medicare. Hospices must periodically undergo inspection to be sure they are meeting regulatory standards in order to maintain their license to operate and the certification that permits Medicare reimbursement.

How can I be sure that quality hospice care is provided?

Many hospices use tools to let them see how well they are doing in relation to quality hospice standards. In addition, most programs use family satisfaction surveys to get feedback on the performance of their programs. To help hospice programs in making sure they give quality care and service, the National Hospice and Palliative Care Organization has developed recommended standards entitled ‘Standards of Practice for Hospice Programs’ as one way of ensuring quality. There are also voluntary accreditation organizations that evaluate hospice programs to protect consumers. These organizations survey hospices to see whether they are providing care that meets defined quality standards. These reviews consider the customary practices of the hospice, such as policies and procedures, medical records, personal records, evaluation studies, and in many cases also include visits to patients and families currently under care of that hospice program. A hospice program may volunteer to obtain accreditation from one of these organizations.