Hospice and Palliative Care in Health Care Facilities

Hospice provides comfort and assistance to patients with a terminal or life-threatening illness. The focus of hospice is to provide comfort, not cure an illness. A specially trained team of professionals and caregivers will serve the “whole person,” including his or her physical, emotional, social, and spiritual needs. Hospice also provides support to the patient’s loved ones during the illness and after the patient’s death.

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Hospice services can be provided in your home or in a designated health care facility, such as a nursing home, assisted living community, hospital, or freestanding hospice center. Most nursing homes in West Virginia allow local hospice organizations to provide end-of-life care in their facilities.

Palliative care is a broader term that includes hospice care and other care that emphasizes symptom control but does not require the patient to have an imminently terminal condition or a time-limited prognosis. Palliative care may include a balance of comfort measures that vary across a wide spectrum.

West Virginia has six freestanding and dedicated hospice facilities and palliative care centers:



Services may include:

• comprehensive pain and symptom management;

• room and board;

• nursing care 24 hours a day;

• personal care for patients;

• ongoing guidance to help patients and families plan;

• care for patients with any diagnosis;

• spiritual and emotional support;

• 12 months of grief and loss support after the patient’s death.


Eligibility

If your doctor has certified that you are terminally ill and have six months or less to live (if your illness runs its normal course), you are eligible for hospice services. This applies to anyone of any age with any type of illness. People with Alzheimer’s usually are referred to hospice when they are in the final stages of the illness.

Payment

Several payment options exist for hospice services, but the primary sources are Medicare and private health insurance. Options include:

• private funds;

• health insurance;

• long-term care insurance;

VA Benefits;

Medicaid;

Medicare.

 

To qualify for the Medicare hospice benefit, you must meet all of the following conditions:

• You are eligible for Medicare Part A (Hospital Insurance).

• Your doctor and the hospice medical director certify that you are terminally ill and have six months or less to live if your illness runs its normal course.

• You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness. (Medicare still will pay for covered benefits for any health problems that aren’t related to your terminal illness.)

• You receive care from a Medicare-approved hospice program.


You are responsible for paying out of pocket for any services not covered by insurance or a government program. If you are unable to pay, many hospice programs will provide free care as the result of community donations. Contact your local hospice for more information.



Hospice and Palliative Care Checklist

Printable version

Services

_____ What services will you provide me?

_____ What services will you provide my family and friends?

_____ What will my room look like?

_____ What are the facility’s visiting hours and policies?

_____ May a friend or family member stay with me overnight? Is there a charge?

_____ May my pets come to the facility for visits?

Dining and Food Service

_____ Does the facility accommodate special diets?

_____ When are meals served?

_____ How often does the menu change?

_____ Are meals/snacks available any time?

_____ Are my guests allowed to have meals with me? What is the cost?

Care Plan

_____ Is there a written care plan for each patient?

_____ Will you include my family and me in designing this plan?

Staffing

_____ How many staff members are on duty each shift?

_____ What training and qualifications are required for staff?

_____ Observe staff interactions with patients. Are they positive and courteous?

_____ Does the facility have a volunteer program? If yes, what types of activities do the volunteers perform?

Payment

_____ Will you help me determine whether my private health insurance or long-term care insurance will cover hospice care?

_____ Are you Medicare certified?

_____ Will you assist me in finding a source of payment for your services?

_____ Are there additional costs for certain goods or services?

_____ How much money will I have to pay out of pocket?

Inspections

_____ Is the facility licensed?

_____ When was the facility last inspected?

_____ May I see the results of the inspection?

References

_____ Who owns the facility?

_____ Will you provide me with a list of doctors and other health care professionals who are familiar with your services?

Complaints

_____ Whom should I call with a question or complaint?


Hospice and Palliative Care in Facilities Related Links

Hospice Association of America

Hospice Council of West Virginia

National Hospice and Palliative Care Organization