Hospice Frequently Asked Questions (FAQs) for Healthcare Professionals

Hospice is palliative, not curative. In other words, hospice does not try to cure disease.

Other indications include:

• Repeat trips to the emergency department
• Unrelieved pain
• Worsening cognitive function or increased confusion
• Frequent infections
• Sudden or progressive decline in physical functioning and eating
• Weight loss/difficulty swallowing
• Shortness of breath/oxygen dependence

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Hospice services can begin when a doctor decides the patient’s life expectancy is six months or less. Hospice services are more efficacious if provided for months rather than days or hours. There is general dissatisfaction among families who believe their loved ones were referred to hospice too late. They reported more unmet needs, greater concerns, and lower satisfaction with the overall quality of care.

The prognosis is the physician’s best estimate of how long the illness will take to run its course before the patient dies.

The need may be for a certain religious practice or person, acceptance of a family or cultural tradition, a language other than English, or another unique circumstance. Hospice providers address each patient’s unique needs through a personalized plan of care.

About 90 percent of hospice patients rely on Medicare and Medicaid to cover their care, and the rest turn to other financing sources, which for most people means private insurance. Most private health plans align with Medicare in their requirements for hospice: A patient must be diagnosed with a terminal illness (indicating a life expectancy of six months or less) and must choose not to receive curative treatment.

Most people enroll in health insurance plans through an employer or retirement program, while others purchase plans through a private or public exchange. Individuals who do not have Medicare but have coverage from private insurance should contact their health plan directly for specific details on hospice care, including what the patient’s plan will cover and which out-of-pocket costs the patient and their family may be responsible for. Medicaid provides coverage, but it varies by state.

Hospices employ financial specialists to help find resources for families who do not qualify for federal assistance and do not have insurance. Payment options can include self-pay and charitable organizations.

For example, if a hospice patient with cancer is involved in an accident and breaks a leg, the ED and physician charges would be paid via regular medical insurance. Hospice would continue to cover the patient’s comfort care. The patient need not and should not revoke their hospice benefit in order to receive emergent care for the broken leg.

The Medicare hospice benefit can be discontinued if the patient requests treatment for the terminal illness that is different from what hospice provides. The Medicare hospice benefit can also be resumed at any time.

Contact VITAS to learn more about how we work with HMOs.

The team manages the patient's clinical and psychosocial needs.

That place may be a private residence, an assisted living community, or a nursing facility. Patients can also receive hospice services while in the hospital or an inpatient hospice unit.

Typically, the goal of home health is to help the patient become more independent. Therefore, home health visits become less frequent as the patient’s condition improves. This situation rarely occurs in hospice care.

The focus of hospice is the physical, emotional, and spiritual end-of-life needs of the resident, the family, and even the nursing home staff.

Patients can move among these four levels as their needs change:

1. Routine hospice care in the home
2. Shifts of acute symptom management at the patient’s bedside for up to 24 hours/day per Medicare guidelines. VITAS calls this Intensive Comfort Care^®; it is also called “continuous home care.”
3. Around-the-clock inpatient care when symptoms cannot be managed at home.
4. Respite inpatient care for the patient when the family caregiver is away 1−5 days.

Headquartered in Miami, Florida, VITAS operates 48 hospice programs in 15 states and the District of Columbia. VITAS employs 11,946 professionals who care for terminally ill patients daily, primarily in the patients’ homes, but also in the company’s inpatient hospice units as well as in hospitals, nursing homes, and assisted living communities/residential care facilities for the elderly.

We offer 24-hour support. Our nurses are available at all times, even weekends and holidays. Our patients receive individualized care plans to ensure their needs—physical, emotional, spiritual—and those of their families are always met.