Patient Referral Form
[gravityform id=”1″ title=”false” description=”false” ajax=”true”]Eligibility Checklist
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Entitled to Part A of Medicare and/or Medi-Cal Eligible, or other funding (private pay, HMO)
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Certification of Terminal Illness (CTI) – based on physician’s medical judgment regarding the normal course of illness with life expectancy of 6 months or less of terminal illness.
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Local Coverage Determination –
- General decline in clinical status
- Non-disease specific baseline guidelines
- Disease specific guidelines
Frequently Asked Questions
What is hospice care?
Considered to be the model for quality, compassionate care for people facing a life-limiting illness or injury, hospice care involves a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes. – National Hospice and Palliative Organization
Who needs hospice care?
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- Patients with a limited life expectancy (a physician’s prognosis of six months or less)
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- Patients no longer willing to seek aggressive medical treatment
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- Patients who want to remain in a comfortable and familiar environment
- Patients who want to maintain the highest possible level of quality of life
Does Medicare Pay for Hospice?
Hospice is 100% covered by Medicare. All hospice related medications, durable medical equipment, medical supplies, respite care, and inpatient care related to the hospice diagnosis are allowable charges. Most private insurance plans also offer hospice benefits.
Anyone can initiate hospice services, including the patient. Certification from the patient’s attending physician and the ANX hospice medical director is required to begin services.
Who is Eligible for Hospice?
Persons with any advanced illness are eligible for hospice, and there is no age or disease restriction. Common diagnosis include:
- ALS
- Alzheimer’s Disease
- Cancer
- Congestive Heart Failure
- COPD
- End-Stage Dementia
- Stroke
- End-Stage Lung, Kidney, or Renal Disease
- Multiple Sclerosis
- Parkinson’s Disease
Other signals for hospice care include:
- Individuals with a limited life expectancy (a prognosis of six months or less)
- Individuals no longer willing to seek aggressive medical treatment
- Individuals who want to remain in a comfortable and familiar environment
- Individuals who want to maintain the highest quality of life
- Individuals who have questions about the California End of Life Option Act
How does hospice care begin?
Typically, hospice care starts as soon as a formal request or a ‘referral’ is made by the patient’s doctor. Often a hospice program representative will make an effort to visit the patient within 48 hours of that referral, providing the visit meets the needs and schedule of the patient and family/primary caregiver. Usually, hospice care is ready to begin within a day of the referral. However, in urgent situations, hospice services may begin sooner.
What services are provided with hospice care?
Hospice Care takes an Interdisciplinary Approach. Your Hospice Care Team will include:
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- Medical services
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- Nursing services
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- MSW
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- Spiritual services
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- Home Health Aid support
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- Volunteer services
- Bereavement services
Other services could include:
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- PT/OT/ST for comfort goals
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- Medical equipment and supplies related to hospice diagnosis
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- Pain Management and Comfort Care
- Individualized Patient/Family education and coaching
Where is hospice care provided?
Hospice care is a service, not a place. We can provide hospice care in the following settings:
- Home
- Board & Care Facility
- Assisted Living Facility
- Skilled Nursing Facility*
- Hospitals*
*A hospice contract with the agency is required
Does hospice provide 24/7 and after-hours care?
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- Hospice care is available ‘on-call’ after the administrative office has closed, seven days a week, 24 hours a day. We have nurses available to respond to a call for help within minutes, if necessary, especially if a patient falls under a higher level of care that requires short term direct care, monitoring, and support to manage a period of crisis.
- A patient’s level of care is determined by the Hospice Interdisciplinary Team.
Do I need to be homebound to receive hospice care?
No, the “homebound” criteria does not need to be met to qualify for hospice care.
Why do hospices have volunteers?
When hospice care became a part of Medicare in 1982 and written into law under President Ronald Reagan, it became a requirement that community volunteers had to provide a minimum of 5 percent of the total patient care hours. This is one of the things that make hospice care unique in healthcare. The thinking was that volunteers would provide a kind of care and a point of view that neither the professional health providers on the team nor the family, who is also part of the hospice team, would offer.
Today every Medicare certified hospice – private or public, secular or or faith based, profit or nonprofit trains community volunteers to provide 5 percent of patient care hours. It’s the law.
What role does the hospice volunteer serve?
Hospice volunteers are generally available to provide different types of support to patients and their loved ones including running errands, preparing light meals, staying with a patient to give family members a break, and lending emotional support and companionship to patients and family members.
Because hospice volunteers spend time in patients’ and families’ homes, each hospice program generally has some type of application and interview process to assure the person is right for this type of volunteer work. In addition, hospice programs have an organized training program for their patient care volunteers. Areas covered by these training programs often include understanding hospice, confidentiality, working with families, listening skills, signs and symptoms of approaching death, loss and grief and bereavement support.