The patient must reside within Hospice’s service area. The patient must be entitled to receive covered Hospice services under the Social Security Act (Medicare and Medicaid) or have other funding source. Medicare patients must be certified as being terminally ill with a prognosis of six (6) months or less, if the terminal illness runs its normal course.
Hospice admits a patient only on the recommendation of the Medical Director in consultation with, or input from the patient’s attending physician (if any). In reaching a decision to certify that the patient is terminally ill, the Medical Director must consider at least the following information:
- Diagnosis of the terminal condition of the patient.
- Other health conditions, whether related or unrelated to the terminal condition.
- Current clinically relevant information supporting all diagnoses.
Hospice will not deny admission to patients with communicable disease, including, but not limited to, HIV, MRSA, TB and Hepatitis B. Care follows a written plan of care established by the Inter-Disciplinary Group(IDG) and reviewed at least every 15 days and IDG. Care will continue under the general supervision of the Medical Director. Care will be available to all patients who can benefit regardless of race, color, religion, national origin, sex, sexual preference, disability, age, socioeconomic level, and marital status, source of payment or diagnostic status.
Each referral is evaluated by the Manager of Patient Services and/or Director to determine the appropriateness of Hospice care. No patient is refused care due to lack of financial means to pay for services. All patients, who meet the requirements, are accepted regardless of ability to pay.
Levels of Services
Routine Home Care Patient at home with symptoms controlled A patient will be placed at this level of care if he or she resides at home (or a long-term care facility) and does not have symptoms which are out of control. These symptoms could include—but aren’t limited to—severe pain, continuous nausea and vomiting, bleeding, acute respiratory distress, and unbearable restlessness or agitation.
General Inpatient Care Patient in facility with uncontrolled symptoms A hospice patient may require inpatient care when his or her symptoms have gotten out of hand and can no longer be managed at home. When these symptoms cannot be controlled on routine home care, then the patient requires extra attention until these symptoms subside. Hospices take aggressive actions to control the symptoms and make the patient comfortable. In order to do this, the patient may be temporarily placed in a skilled facility or an acute care hospital. At this level of care, a moment-to-moment assessment of what’s happening and what needs to be done takes place. The hospice team and the patient’s physician work together to ensure the patient obtains and maintains a tolerable comfort level. Once this has been achieved, the patient will return home and back to routine home care.
Impatient Respite Care Patient at facility with symptoms controlled A patient may be moved to respite care when the caregiver needs a break. Respite care allows a patient to be temporarily placed in a facility with 24-hour care so the family can rest. The patient will be transferred to the facility, and according to Medicare regulations, can stay for up to five days before being transferred back home.
Continuous Nursing Care Patient at home with uncontrolled symptoms A patient would receive continuous nursing care if he or she has symptoms that are out of control and choose to stay at home. This is similar to inpatient care, except that the patient remains in his or her home instead of being placed in a facility. A hospice nurse is required to provide (continuous around-the-clock nursing) care if the symptoms cannot be controlled while on routine home care. Hospice staff will provide a minimum of eight (8) hours of care per calendar day