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What is Hospice?

Hospice offers medical care toward a different goal: Maintaining or improving the quality of life for someone whose illness, disease or condition is unlikely to be cured. Each patient’s individualized care plan is updated as needed to address the physical, emotional and spiritual pain that often accompanies terminal illness. Hospice care also offers practical support for the caregiver(s) during the illness and grief support after the death. Hospice is something more that is available to the patient and the entire family when curative measures have been exhausted and life prognosis is 6 months or less.

​History of Hospice

In Western society, the concept of hospice has been evolving in Europe since the 11th century. Hospice were places of hospitality for the sick, wounded or dying, as well as those for travelers and pilgrims. The modern concept of hospice, includes palliative care for the incurably ill given in such institutions as hospitals or nursing homes, but also care provided to those who would rather spend their last months and days of life in their own homes.

It began to emerge in the 17th century, but many of the foundational principles by which modern hospice services operate were pioneered in the 1950s by Dame Cicely Saunders, when she opened St. Christopher’s Hospice in 1967. St. Christopher’s Hospice in London emphasized the multi-disciplinary approach to caring for the dying, the regular use of opioids to control physical pain and careful attention to social, spiritual and psychological suffering in patients and families.

Within the United States, the term is largely defined by the practices of the Medicare system and other health insurance providers, which make hospice care available, either in an inpatient facility or at the patient's home, to patients with a terminal prognosis who are medically certified at hospice onset to have less than six months to live.

Hospice care also involves assistance for patients’ families to help them cope with what is happening and provide care and support to keep the patient at home.

In 1969, Elisabeth wrote On Death and Dying, coining the 5 stages of death: Shock/Denial, Anger, Bargaining, Depression and Acceptance.

Dame Dr. Cicely Saunders

St. Christopher’s Hospice

Elisabeth Kübler-Ross

​How does hospice work?

1

Assessment by Patient's Doctor

2

Local Coverage Determination

3

Certificate of Terminal Illness

4

Election of ​Hospice

"We'll walk with you along the way ..."

5

Initial​Assessment

6

Comprehensive​Assessment

7

Interdisciplinary​Team Meeting

8

Plan​of Care

​Who pays for hospice?

Hospice care is paid for by Medicare, Medicaid in most states, the Department of Veterans Affairs, most private insurance plans, HMOs and other managed care organizations. Also, community contributions, memorial donations and foundation gifts allow many hospices to give free services to patients who can’t afford payment. Some programs charge patients according to their ability to pay.

Medicare

The most common option to pay for hospice care because nearly all hospice patients qualify for Medicare. In most cases, you pay nothing for hospice care, but you may have co-pays for prescriptions. You also have to pay a percentage of the bill for inpatient respite care.

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Medicaid

Converts into Medicare for Hospice coverage. However, Medicaid may cover some expenses like respite and GIP not related to Hospice care to ensure the patient has no out-of-pocket expenses.

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Veterans can receive hospice care through the Veteran’s Administration. The VA can purchase hospice services from community providers, including hospice care provided at home or in an institution as an inpatient.

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Private Insurance

Most private health insurance companies, include hospice care as a benefit. Be sure to ask about your insurance coverage, not only for hospice, but also for home care.

Private Pay

If insurance coverage is not available or does not cover all costs, the patient and the family can hire hospice providers and pay for services out of pocket. Some hospices are able to provide services without charge if a patient has limited or no financial resources.

​Admission Process/Notice of Election

Assessment by Patient's Doctor or Referral to our Physicians/MD

Patient must remain under the supervision of a physician either by their current doctor or elect to have our medical director and associate physicians be their attending physician.​​