Frequently Asked Questions
When is the right time to ask about hospice?
Now is the best time to learn more about hospice and ask questions about what to expect from hospice services. Although end-of-life care may be difficult to discuss, it is best for family members to share their wishes long before it becomes a concern. This can greatly reduce stress when the time for hospice is needed. By having these discussions in advance, patients are not forced into uncomfortable situations. Instead, patients can make an educated decision that includes the advice and input of family members and loved ones.
Who is eligible for hospice?
An individual may be eligible for hospice through Medicare or private insurance when the patient’s personal physician and the hospice medical director certify that the he or she has a prognosis of six months or less should the disease process run its natural course.
How does hospice care begin?
Typically, hospice care starts as soon as a ‘referral’ is made by the patient’s doctor. Representatives from the hospice team try to schedule a visit to the patient within 48 hours of that referral. Usually, hospice care is ready to begin within a day or two of the referral. However, in urgent situations, hospice services may begin sooner.
Who pays for hospice?
Hospice is a covered benefit through Medicare Part A. However, most hospices work with private insurance companies, Medicaid, and even the Department of Veterans’ Affairs. It covers medications (related to the hospice diagnosis)that bring the patient comfort, medical equipment such as beds, incontinence supplies, and other equipment that may be needed.
Does hospice do anything to make death come sooner?
We do not make efforts to hasten the death process. This is a common misconception. Because we deal with death at hospice, many think that we try to offer increased amounts of medication that will help move the inevitable along more quickly. Instead, we focus on improving the quality of life, and help prepare patients and their families so that they can experience the best possible transition to the ending of life.
Where do patients receive care?
Patients receive care in their homes, whether that is a private residence, a nursing home, or an assisted living facility.
What if I don’t feel comfortable talking to my loved one about death?
Our hospice team is comprised of professionals who are specially trained to discuss death and dying with patients. Our nurses, social worker, chaplain and Doula are able to discuss these sensitive issues with patients and their loved ones. They can teach you how to talk to your loved one and help facilitate these difficult conversations.
What if my mother or father has special needs?
Because we design an individualized plan of care, we take into consideration the special needs of our patients. We are able to provide special equipment, such as wheelchairs or lifts, as well as specific therapies, such as respiratory, speech, or physical therapy.
What if we follow specific religious or cultural practices?
The hospice team members are dedicated to serving our patients and their family members as best we can. We respect and honor our patients’ religious and cultural beliefs, practices, and values. We adhere to the principles of Joint Commission on the Accreditation of Healthcare Organizations (JCAHO, 1998), which state, "patients have a fundamental right to considerate care that safeguards their personal dignity and respects their cultural, psychosocial, and spiritual values."
Can a hospice patient who shows signs of recovery go off hospice and resume regular medical treatment?
Of course! Disease does not always follow a specific course, and sometimes, patients experience improvement in their condition. They may graduate (be discharged from hospice) if the disease does not seem to be getting worse. Patients are able to return to hospice care if needed.
Can a patient remain on hospice while receiving curative treatments?
Patients who are referred to hospice will begin to receive palliative care, or care that is focused on keeping the patient comfortable, rather than aggressive treatments that are designed to be curative in nature. However, patients may need treatments or medications for other conditions that are not related to their primary illness, such as high blood pressure, or diabetes. The hospice staff will work with the attending physician to ensure the proper management of symptoms.
Will I be able to keep my health insurance?
Yes. Hospice provides care that is related to the primary diagnosis. Your HMO or PPO can address conditions that are not related.
How long does my hospice benefit last?
There are two ninety (90) day and one sixty (60) day benefit periods, after which the patient is assessed for continuation of services. The benefit period does not need to be consecutive. After the first 90 day period, if the terminal condition is not progressing, the patient may graduate from hospice until his or her medical condition warrants resumption of coverage and the hospice Medical Director recertifies the patient. The patient may revoke the election of the hospice benefit at any time without penalty.
What emergency services are available under the hospice medicare program?
Hospice providers are First Responders for patients, and we do not use 911. However, we are available by phone 24 hours a day, 7 days a week. Services are provided by on-call team members who are available to visit patients and families as necessary. All care is provided through coordinated efforts of the physician, family, care center staff, and the hospice team.
What services are available under the Medi-Cal Program?
The state of California provides reimbursement for hospice care through the Medi-Cal Program for eligible patients. The eligibility requirements for hospice coverage under Medi-Cal are identical to those of Medicare. The provider of services must be a medical provider. Hope Springs Hospice is a Medical hospice provider, licensed by the Department of Health Services.
We are being pressured to choose the specific hospice that is affiliated with the hospital or nursing home we are working with. What can we do?
It is your choice to elect the hospice that you feel most comfortable with. It is illegal for any agency to require you to work with a specific hospice. Even if you are a patient in a nursing home or hospital, you may choose to go with another hospice.
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 do we know if a patient is eligible for hospice?
In order to be eligible to elect hospice care under Medicare, a patient must be entitled to Part A and certified as being terminally ill by a physician and having a prognosis of 6 months or less if the disease runs its natural course.