Hartford HealthCare at Home - Hospice Care is dedicated to providing physical, emotional, social and spiritual support to terminally ill patients, as well as their families and loved ones, while assisting patients and families to live with dignity and comfort as they cope with end-of-life issues.
What is Hospice? Why Hospice? About Hospice Admission to Hospice Levels of Hospice Care Plan of Care Medicare Benefit Charges
What is Hospice?
Hospice is primarily a home care program, but services may also be provided in a hospital, nursing home, assisted living facility or wherever the patient calls home. The hospice team helps the patient and family make informed decisions about caregiving, teaches the necessary skills for "Hands-on" care and helps with the approaching and actual death. Hospice also offers help through the bereavement period up to 13 months after a patient has passed away.
Hartford HealthCare at Home is committed to ensuring your rights and privileges as a hospice patient. If you have additional questions, please do not hesitate to ask us.
Hospice care provides comfort and kindness to those persons nearing the end of life's journey. It will help you make decisions about how and where you want to spend the rest of your life.
- Hospice affirms life.
- Hospice recognizes dying as a process and our care provides comforts rather than cures.
- Hospice neither hastens nor postpones death.
- Hospice provides physical, emotional and spiritual care to terminally ill persons and their families.
- Hospice helps the terminally ill person maintain quality of life and helps family members through an extremely stressful time in their lives.
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- Hospice treats you, not the disease. The focus is on care, not cure. You and your family's medical, social, emotional and spiritual needs are addressed by a team of hospice professionals and volunteers.
- Hartford HealthCare at Home Hospice Services considers your entire family, not just you, as the "unit of care". You and your family are included in the decision-making process. Hospice will help you and your family make choices about end of life issues and enable you to have greater control over these choices.
- Hospice offers palliative, rather than curative, treatment. Hospice will provide care and comfort when cure or treatment are no longer options. Through ever advancing technology, pain and symptom control will enable you to live as fully and comfortably as possible.
Hospice services include Nursing, Medical Social Services, Physician Services, Hospice Aide/Homemaker Services, Volunteer Services and Spiritual, Dietary and Bereavement Counseling. All services are provided under the direction of a physician and/or the Hospice Medical Director. Arrangements will be made for hospice approved medications, medical supplies and equipment, as appropriate.
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About Hospice Care
Hospice is a philosophy of caring for those living with a life-threatening illness.
The hospice philosophy holds that end-of-life care should emphasize quality of life. The object is to treat the whole person, and not just the disease. The hospice philosophy focuses on patient/family-centered care that addresses the physical, spiritual, emotional, and practical needs of the patient. An interdisciplinary team of health care professionals works with the patient and family to design and implement a plan of care unique to the patient's diagnosis. In addition, hospice provides all medications, services and equipment related to the terminal illness. Hospice care does not end with the patient's death; it continues with up to 13 months of bereavement counseling for the family and loved ones.
Hospice cares for people where they live.
Although some hospice care is provided in hospitals, in-patient hospice facilities or nursing homes, the vast majority of patients are cared for in the place they call home.
Hospice is a Medicare benefit.
Congress's Medicare Hospice Benefit of 1983 was established to ensure that all Medicare beneficiaries could access high-quality end-of-life care. Hospice became an optional Medicaid benefit as a part of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA '85). Americans are now promised the opportunity to live the end of their lives free of pain and with emotional spiritual support. More than 80% of hospice patients are Medicare beneficiaries.
Hospice care is reimbursed on a per diem basis.
The Medicare reimbursement for hospice care is a set rate per day. There are four hospice rates each linked to one of the four levels of hospice care, general inpatient care, respite care, and continuous care. The routine home care rate, at which more than 96 percent of all Medicare hospice patients are billed, is approximately $126 per day.
Hospice care is not limited to cancer patients.
Hospice now cares for over half of all Americans who die from cancer and a growing number of patients with other chronic, life-threatening illnesses, such as end-stage heart or lung disease. America's hospices are leaders in caring for patients with HIV-AIDS.
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Admission to Hospice
Admission to our hospice program is made upon the recommendation of your physician and is based upon your needs. Normally, appropriate candidates for hospice are patients:
- Who meet strict clinical criteria
- With a life expectancy of 6 months or less if the illness runs its normal course
- Who desire palliative treatment
- Who want to stay at home as long as possible
- Who have a primary care person
Hartford HealthCare at Home Hospice Care Services will visit you or your family to discuss hospice services, assist your immediate needs and recommend a plan of care in any setting.
If we cannot meet your needs, either directly by our hospice or indirectly through service agreements with other providers, we will not admit you for care. However, we are able to assist you in your search for an appropriate care setting.
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Levels of Hospice Care
Routine Home Care
Care is provided intermittently by hospice team members in the patient’s or family’s home or in a nursing care facility.
General Inpatient Care
Care is provided at a contractual hospital, skilled nursing facility or inpatient hospice facility for patients who need pain control or acute/chronic symptom management which cannot be managed in other settings. The necessity for inpatient care and paid length of stay will be determined by the hospice interdisciplinary group. If a hospice patient needs hospitalization for any reason unrelated to the terminal diagnosis, traditional Medicare Part A will be utilized.
Inpatient Respite Care
Up to five (5) days of respite care at a contractual hospital, nursing care facility or inpatient hospice facility will be paid by hospice, if approved by the hospice interdisciplinary group. This benefit may be used to give the family/caregiver a rest and the patient does not need to meet acute care standards.
Continuous Home Care
A minimum of eight (8) hours of care per day may be provided during periods of crisis to maintain the patient at home. Criteria for continuous home care are the same as general inpatient care and consist predominantly of nursing care; however, hospice aides or homemakers may also supplement nursing care.
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Plan of Care, Treatments & Services
Our hospice involves key professionals and other staff members in developing your individual plan of care, which is based upon identified problems, needs and goals, physician orders for medications, treatments and care, your environment and your personal wishes whenever possible. Effective pain management is an important part of your treatment plan.
The plan includes five basic areas:
- Physical care
- Personal care and comfort
- Spiritual needs
- Psychosocial needs
- Bereavement care
The plan is reviewed and updated as needed, based on your changing needs. We encourage your participation and will provide necessary medical information to
We fully recognize your right to dignity and individuality, including privacy in treatment and in the care of your personal needs. We will always notify you if an additional individual needs to be present for your visit for reasons of safety, education or supervision. Prior to anyone visiting your home, we will ask your permission. You have the right to refuse any visitors and this will not compromise your care in any way.
Discharge, transfer or referral from hospice may result from several types of situations, including the following:
- The hospice determines that the patient is no longer terminally ill
- The patient moves out of the hospice’s service area
- The patient transfers to another hospice
- The patient’s behavior (or situation) is disruptive, abusive or uncooperative to the extent that delivery of care to the patient or the ability of the hospice to operate effectively is seriously impaired
- Issues of patient or staff safety that cannot be resolved
- Patient/family requests to end (revoke) the services of the hospice.
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The Medicare Hospice Benefit
Most insurances have a hospice benefit that mirrors the Medicare Hospice benefit. Medicare will reimburse the cost of hospice care under your Medicare Hospital Insurance (Part A).
When all requirements are met, Medicare will cover the following services, as appropriate, and when included in the Plan of Care:
- Physician services
- Nursing care
- Medical appliances and supplies
- Medications for symptom management and pain relief of the terminal illness and related conditions (must be pre-approved by hospice)
- Short-term inpatient care for pain and symptom control
- Hospice aide/homemaker
- Spiritual counseling
- Bereavement counseling
- Physical therapy, occupational therapy, speech therapy
- Medical social services
- Dietary counseling
- Volunteer services
- Short-term respite care
The following are non-covered services (Notice of Medicare non-coverage):
- Treatment for the terminal illness, which is not for palliative symptom management and is not within the hospice plan of care
- Care provided by another hospice that was not arranged by the patient's hospice
- Ambulance transportation not included in the plan of care
- Medications that are not related to the terminal illness
- Visits to the emergency department or admission to the hospital without the prior approval or arrangements by hospice
- Inpatient care at non-contracted facilities
- Sitter services/hired caregivers
- Lab studies, medical testing and/or any treatments not indicated
- Hospice will cover all medication related to the terminal illness and related conditions.
These medications will be provided by our hospice pharmacy and cannot be filled at your local pharmacy without our approval. If you have a Medicare Part D prescription drug plan, this may continue to pay for some medications for illnesses unrelated to the terminal illness.
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In most cases, your insurance company will pay hospice directly; however, not all insurance plans provide full coverage for hospice care and some hospice services may not be covered under your plan. We receive our reimbursement from Medicare, Medicaid and private health insurance for services. All third party payers are billed for hospice services as appropriate.
All patients, who meet the requirements, are accepted regardless of ability to pay. Medicare or Medicaid patients will not be refused care or have their hospice care discontinued or reduced due to their inability to pay for that care. Our social worker will meet with the patient/family to determine concerns and needs. Should any change be made in this policy regarding services or charge, you or your responsible party will be advised. Please call our office if you have questions about charges or insurance billing.
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