AMERICAN VETERANS HOSPICE is committed to honoring the end of life journey. By managing pain and symptoms, we enable our patients to enjoy a high quality of life for as long as they have in the comfort of their own homes. This also allows them to share more special moments with their family and express everything they need to say.
Hospice care is provided wherever the patient calls home, may it be in a hospice house or hospice hospital, while some prefer to receive hospice home care. If you or a loved one want to stay in your family home, we can provide our home hospice services there. If you are in an assisted living facility or nursing home, we can partner with the facility to provide extra specialized end-of-life care.
When you are receiving hospice care, you will get visits from your team of healthcare professionals including nurses, aides, chaplains, social workers, and volunteers. Each has been trained to address your physical, mental, emotional, spiritual, and personal care needs.
Your hospice care team will evaluate your condition as determined by the customized care plan. Generally, the care plan includes:
- Administering medication
- Pain and symptoms management
- Wound care
- Assisting with personal care
- Providing companionship
- and more
Who pays for Hospice Care?
Hospice care is financially covered by Medicare, medi-cal, the Veteran’s Administration, most private insurers, long-term care insurance, and even some life insurance or annuity policies that cover terminal illness.
This means all medications, medical equipment, and medical supplies related to your terminal illness will be provided at no cost to you or your family. For payer sources other than Medicare or Veterans Administration, there may be limited hospice levels of care due to the insurance company’s daily limits.
Items & Services Included in the Medicare Hospice Benefit:
The Medicare hospice benefit includes the following to reduce pain or disease severity and manage the terminal illness and related conditions:
- Services from a hospice-employed physician, nurse practitioner (NP), or other -physicians chosen by the patient
- Nursing care
- Medical equipment
- Medical supplies
- Drugs to manage pain and symptoms
- Hospice aide and homemaker services
- Physical therapy
- Occupational therapy
- Speech-language pathology services
- Medical social services
- Dietary counseling
- Spiritual counseling
- Individual and family or just family grief and loss counseling before and after the patient’s death
- Short-term inpatient pain control and symptom management and respite care
Individuals with a life-threatening illness and a life expectancy of six (6) months or less following the normal cause of the disease may choose comfort care instead of curative or aggressive treatment.
Hospice Eligibility Requirements:
A patient diagnosed with a life-limiting condition, with a life expectancy of six months or less if their disease runs its normal course.
- Palliative Performance Scale (PPS) rating of 50%-60% Dependent in at least 3 of 6 Activities of Daily Living (ADLs)
- Alteration in nutritional status (e.g. 10% loss of body weight over last 4-6 months)
- Observable and documented decline in the clinical condition in the last 4-6 months as manifested by at least one of the following:
- ≥ 3 hospitalizations or emergency department visits
- Decrease in tolerance to physical activity
- Decrease in cognitive ability
- Other comorbid conditions
To qualify for hospice care services, a hospice doctor and your doctor (if you have one) must certify that you are terminally-ill and that you have a life expectancy of 6 months or less. When you agree to hospice care, you are agreeing to palliative care instead of opting for care to cure your illness. You must also sign a statement choosing hospice care instead of other benefits Medicare covers to treat your terminal illness and related conditions.
Disease-Specific Hospice Eligibility Criteria
There are specific criteria to consider based on the patient’s primary diagnosis. The diseases below are generally applicable requirements for hospice care, amongst other eligibility requirements.
- Cerebral Vascular Accident (CVA) / Stroke
- Congestive Heart Failure
- COPD / Cardiopulmonary Disease
- Liver Disease
- Neurological Conditions (non-Alzheimer’s dementia)
- Parkinson’s disease
- Multiple Sclerosis
- Hungtingtons Disease
- Renal Disease
Hospice Levels of Care
Generally, Medicare pays hospice agencies a daily rate for each day a patient is enrolled in the hospice benefit. The daily payment rates cover the hospice’s costs for providing services included in patient care plans.
Medicare makes daily payments based on 1 of 4 levels of hospice care:
- Routine home care: A day the patient elects to get hospice care at home and isn’t getting continuous home care. A patient’s home might be a home, a skilled nursing facility (SNF), or an assisted living facility. Routine home care is the level of care provided when the patient isn’t in crisis.
- Continuous home care: A day when both of these apply:
- The patient gets hospice care in a home setting that isn’t an inpatient facility (hospital SNF or hospice inpatient unit)
- The care consists mainly of nursing care on a continuous basis at home
- Patients can also get hospice aide, homemaker services, or both on a continuous basis. Hospice patients can get continuous home care only during brief periods of crisis and only as needed to maintain the patient at home.
- Inpatient respite care: A day the patient elects to get hospice care in an approved inpatient facility for up to 5 consecutive days to give their caregiver a rest.
Coinsurance will apply as per the Medicare plan
- General inpatient care: A day the Agency Interdisciplinary Group recommends hospice care in an inpatient facility for pain control or acute or chronic symptom management which can’t be managed in other settings.
Coinsurance will apply as per the Medicare plan
Honoring Life Through Creating Memories
Celebrating life is a critical part of the journey and we will help you with that.
Emotional Support and Spiritual Care
Including specially trained compassionate specialists to provide spiritual/pastoral care that honors traditions and teachings of all different faiths. Being veteran-owned, our care also encompasses honoring the unique life journey of military veterans as they approach the end of life.
Nursing Care in Your Home
Visit frequencies vary by discipline type and are contingent upon the plan of care as evaluated by our care team and hospice physician. Collectively, they provide medical, physical, emotional, and spiritual support to the patient by monitoring pain, managing symptoms, addressing dietary needs, evaluating for emotional concerns as well as offering support to both the patient and the family. Education is also a priority for our care team, as they will teach the family or family caregiver how to provide the best personal care to the patient. For after-hours needs, we provide 24-hour telephone access to clinicians who can answer questions, support caregivers over the phone, or dispatch a nursing team for as needed critical needs.
Grief and Bereavement
Surviving family members are part of the journey as well and have access to E-bereavement resources and up to 12 months of support as needed.
Our chaplain and bereavement team are here to support family members for up to 12 months after their loss. Services begin with a bereavement assessment as it’s customized to the family member’s preferences. Telephone visits and alternative e-bereavement services are offered throughout the process as well.