Makes the Most of Every Day
concept of care is built on an interdisciplinary approach that incorporates
the coordinated services of health care professionals and trained volunteers
to meet the unique needs of patients facing a life-limiting illness
and their families. Hospice care is a form of palliative care, specifically
for individuals with a life-expectancy of six months or less (as determined
by their physician), whose goals for care focus on palliation (comfort
measures) rather than cure of the underlying disease.
is not about death, but rather about the quality of life as it nears
its end. It is not a
place to send people to die and is not about last minute hospital care.
services provide medical, emotional, spiritual and social support to
patients and families experiencing end of life issues. Intermittent
care is provided by hospice professionals and it is not a substitute
for the family or family's care. Hospice
treats the person, not the disease and focuses on the family, not just
the individual. To this end, care is provided in the
patient's home setting where comfort and security are enhanced by familiar
· For information on Hospice Myths & Facts,
please click here.
· For information on Hospice Frequently Asked Questions, please click here.
· For information on the CMS Hospice Payment System,
please click here.
· For information on the CMS Hospice Benefit - Official Booklet, please click here.
· For information on NHPCO Hospice Facts and Figures,
please click here.
is a specialized concept of caring for those with life-limiting illness. Patients, with any of the following illnesses or end-stage diseases, may be appropriate for a hospice referral once eligibility criteria are met:
· Amyotrophic Lateral Sclerosis (ALS)
· Cardiovascular Diseases
· Lung Disease
· Liver Disease
· Renal Diseases
No one is denied service because of age, race, color, creed, gender, national origin, sexual orientation, religion, disability, diagnosis or the ability to pay.
Level of Care Services
referral is made, the admissions team, along with the patient's Attending
Physician and Hospice Medical Director, will decide the level of care
needed. The following levels as certified by Medicare include:
Routine Care: Over 96% of all hospice care is provided intermittently
in the comfort and security of the patient's home or in a long-term care facility, with patient symptoms controlled.
· Continuous Care: Only used for a period of crisis, this
level of care is covered as necessary to maintain the patient at home. A period of crisis is when a patient requires pain control and symptom management which is primarily skilled nursing care. Once the acute crisis has ended, the patient will be returned to routine care.
· General Inpatient Care: General Inpatient Care is appropriate when the patient's family is unable to care for the patient at home. This level of care is also appropriate for pain and symptom control as well as for the management of acute psychosocial issues. General Inpatient Care is provided in a contracted skilled nursing facility, where a registered nurse is available to provide care 24 hours a day, 7 days a week with hospice associates continuing to visit the patient daily to manage care.
· Respite Care: Respite Care is short-term inpatient care provided to individuals residing at home when necessary to relieve the caregiver. Respite care may be provided on an occasional basis and may not be reimbursed for more than five consecutive days at a time. During respite care the patient is transferred to a hospice contracted nursing facility that provides 24 hour nursing care. Hospice associates will continue to visit the patient daily to manage care.
· Private Pay: Arrangement can be made for additional
palliative services beyond the plan of care.
Hospice Care is a covered benefit of Medicare Part A, Medicaid (AHCCCS)
& most insurance companies
· In the past
year, less than 20% of Medicare patients that were diagnosed terminally ill used the free hospice benefit
· The Hospice benefit is FREE with NO out-of-pocket expenses
for the diagnosis
· Enrolled patients are entitled to a minimum benefit of $4,000.00
per month, including covering medications, medical equipment
and supplies directly related to the diagnosis
· Care is provided in the patient's home during normal business
hours and on an on-call basis 24 hours a day, 365 days a
· Hospice patients may visit their primary physician for any
symptoms not related to their hospice diagnosis--non-hospice
diagnosis related care is provided additionally by the patient's
Medicare Part A & B coverage or other qualified insurance plans
· Of the over
$500 billion spent annually by Medicare, less than 2% is used for hospice
services (annual health-care spending in the US has topped $2 trillion)
· Hospice is not a basic benefit under the Medicare Advantage (MA) Program and MA Plans are not required to provide a hospice benefit. Enrollees in MA Plans receive the hospice benefit under Original Medcare Part A. Upon enrollment and annually thereafter, MA plans must inform enrollees of the availability of the Medicare hospice option and any approved hospices in the MA Plan's service area including those that the MA organization owns, controls, or in which it has a financial interest
· People who receive hospice have a higher quality of life, lower
medical costs and, according to a recent study, may live
· The Hospice benefit in Medicare, Medicaid (AHCCCS) and health insurance is the model of healthcare in the future
AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES
Palliative Care Research Network
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