About Hospice Care
Considered the model for quality care for people facing a life‐limiting illness, Pacific Coast Hospice provides expert medical care, pain management, personal care, and emotional and spiritual support individually tailored to the patient’s needs and wishes. Support is provided to the patient’s loved ones as well. Hospice focuses on caring, not curing. An interdisciplinary team of professionals is responsible for the care of each hospice patient.
Levels of Care
Benefit Periods & Eligibility
An individual may elect to receive hospice care during one or more of the following election periods:
- An initial 90-day period;
- A subsequent 90-day period; followed by
- An unlimited number of subsequent 60-day periods, if needed.
As long as the patient meets the certification criteria, there is no limit on the amount of time a patient can then spend under hospice care, although the hospice must continue to monitor continued eligibility as a part of the recertification process every 90 days for the first 180 days, and when the 90-day periods are complete, prior to every 60-day benefit period. This monitoring function takes place through the face-to-face encounter, as well as ongoing interdisciplinary team review.
If the patient is a nursing home resident and chooses to elect hospice care, the Medicare Hospice Benefit covers all care and services related to the terminal prognosis. However, the patient may not, except in unusual circumstances, receive their Medicare Skilled Nursing Home benefit at the same time as their hospice benefits. For those eligible for both Medicare and Medicaid, the nursing home’s room and board is paid by the state Medicaid program to the hospice and paid to the nursing home under a contractual arrangement between the nursing home and the hospice. This is pass through billing/contractual arrangement is not applicable to patients in Arizona under AHCCCS.
For the duration of an election of hospice care, an individual waives all rights to Medicare payments for any Medicare services that are related to the treatment of the terminal prognosis for which hospice care was elected. Exceptions include: services provided by the designated hospice, another hospice under special arrangements, or the individual’s attending physician (if the physician is not an employee of the designated hospice or receiving compensation from the hospice for his or her services).
Frequently Asked Questions
We provide trained volunteers to aid the family and patients. Most volunteers are trained to relieve the primary caregivers, do household chores, and provide companionship to patients. Perhaps the most important task, however, is their ability to be good listeners. Volunteers may also support the work of the hospice program that might not involve patient or family interaction.
Most patients receiving hospice care are covered by the Medicare hospice benefit. This benefit covers virtually all aspects of hospice care with little out-of-pocket expense to the patient or family. As a result, the financial burdens usually associated with caring for a terminally ill patient are virtually nonexistent. In addition, most private health plans and Medicaid in most states (AHCCCS in Arizona) cover hospice services.
Appropriately prescribed medicine will not hasten death. Your Hospice Medical Director has the expertise to devise a medication plan that makes you comfortable and is safe. Addiction to pain medication is a common fear but does not frequently occur. Hospice doctors are experts in preventing problems and side effects of strong pain medications. They also can help patients with addictions get pain relief with a referral to a specialist.
Yes. Under hospice, your Hospice Medical Director will coordinate care with your primary physician, subject to your personal doctor’s preferences. Under palliative care, your palliative team coordinates care with your other doctors and helps you navigate the healthcare system.
Hospice care is provided by a team and each patient has a Nurse Case Manager. You can decide if you would also like a hospice aide to give personal care, a spiritual care counselor to talk to or make a referral, a social worker to assist with arranging practical matters, or a volunteer to provide companionship, run errands or keep the patient company.
An advance directive is a written statement of a person’s wishes regarding medical treatment, often including a living will, made to ensure those wishes are carried out should the person be unable to communicate them to a doctor. Other form names may include: Medical Power of Attorney, Healthcare Proxy, or Advance Care Planning.
Hospice services can begin when a doctor decides the patient’s life expectancy is six months or less. Patients should consider hospice services when medical treatments can no longer cure their disease and/or symptom burden outweighs the benefits of treatment. Other indications include: frequent infections, frequent trips to the hospital, falls, sudden or progressive decline in physical function and/or eating, weight loss, or difficulty breathing.
Anyone can request a free hospice evaluation. Sometimes the physician makes the referral or provides several options and lets the patient and/or family decide. The physician must certify to the hospice provider that the patient is eligible and has a prognosis of six months or less. When a referral is made, Pacific Coast Hospice will make an appointment to meet with the patient and family. After that, an admission nurse will evaluate the patient and answer the any questions. If in agreement to begin care, the patient will sign admission paperwork and the admission nurse will begin a plan of care that reflects the patient/family’s wishes.
No. You are eligible for hospice care if you likely have 6 months or less to live (some insurers or state Medicaid agencies cover hospice for a full year). Unfortunately, the vast majority of patients don’t receive hospice care until the final weeks or days of life, missing out on helpful care and quality time.
Ideally, a member of your hospice team will be at the bedside at the time of death, able to explain the stages of death, make necessary phone calls, and support the family. He or she will make arrangements for the body to be moved. If a member of the team is not present at the death, he or she will arrive as soon as you call us. Bereavement support is available for families and friends
Once a disease or condition is no longer considered terminal, discharge from hospice care is appropriate. Patients improve with hospice services generally because the focus of their care shifts to comfort, pain relief, symptom management and quality of life. While they still might have a terminal illness, their symptoms are so improved that they no longer qualify for hospice care. Patients can also return to hospice at any time, as long as their doctor re-certifies their eligibility.