Frequently Asked Questions About Home Health & Hospice Care

Home health is a doctor, nurse practitioner or physician assistant-ordered service designed to help patients improve their ability to function safely at home by teaching patients and their caregivers how to provide effective, appropriate care. Symptom management, medication management, mobility and home safety issues are among the many needs covered.

We are happy to answer any questions you may have about the many services we provide. However, we must have an order from a doctor, nurse practitioner or physician assistant to provide care. Talk to your doctor or other healthcare provider about your need for home-based services.

Home health services are specifically designed to deal with acute medical changes in a patient’s condition. These changes can relate to a worsening of a long-standing diagnosis, a new diagnosis, or a need for support during recovery from a serious illness, injury or surgery.

Your doctor, nurse practitioner or physician assistant must determine your need for home-based care and write an order for the care. Medicare, Medicaid and most private insurance companies have homebound and skilled needs requirements that must be met to in order for them to cover home health care.

No. All care is intermittent, with the frequency of visits determined by the doctor and home health clinician. Typically, visits are about 30 to 45 minutes long, two to three times a week. Appointment times are approximate. If constant supervision or care is what you need, we can help provide referrals to services that offer this level of care.

Care can be provided where you live, whether that is your house or a family member’s, an adult family home, assisted living or a retirement home. Home health cannot be provided in a hospital or nursing home (although hospice services can be provided at these locations).

Home health services continue as long as medically necessary, based on the assessment of the nursing or therapy case manager, your provider and your progress.

Medicare pays for home health services under Part A benefits at 100 percent when the patient is eligible for service and meets the criteria for admission. Medicaid coverage of home health services is subject to the limitations of the medical program identified on your medical ID card. We will verify your coverage before our first visit.

Private insurance coverage differs from contract to contract. You will know what the cost will be before service begins.

Medicare regulations define skilled care as services that must be performed by a health care professional that are reasonable and necessary for the treatment of your illness or injury. For example, after a hip replacement, the skills of a physical therapist will be necessary to help your recovery. Our team will work with you and your doctor or other health care provider to determine the kind of skilled care you will need.

If you are receiving skilled services from a nurse or therapist, Medicare will allow a home health aide to assist with your personal care and recovery needs on an intermittent basis.

That type of care is considered nonskilled, or custodial, and is not covered by Medicare, although sometimes it is covered by private insurance or Medicaid. We can help you research the availability of private insurance or Medicaid coverage for those services.

Senior Health Insurance Benefits Advisors (SHIBA) is the best resource to ask about Medicare supplemental insurance. This is a statewide network of trained volunteers who educate, assist and serve people who have Medicare. SHIBA can be contacted at 800-397-4422.

Hospice refers to a range of care services that focus on comfort rather than cure, and embraces patients, families and caregivers as patients reach the end of their life. Comfort care, from the hospice perspective, includes managing physical symptoms to maintain quality of life and manage pain, as well as meeting the emotional and spiritual needs of patients and their families. Our program emphasizes living life as fully and comfortably as possible.

Palliative care and hospice care have many similarities, and both share the goal of providing comfort and improving quality of life. However, hospice care is only available for those facing a life-threatening illness who choose to stop any life-prolonging treatment. Palliative care can be provided to patients at any stage of their illness or treatment. Availability varies by region.

By law, the decision belongs to the patient. If the patient is incapacitated, the power of attorney or legal guardian may decide. Any time during a life-limiting illness can be an appropriate time to discuss all of a patient’s care options, including hospice, with the patient’s doctor or other health care provider. You do not need a doctor’s referral to receive hospice services. If you don’t have a referral, a provider will need to certify that the patient has six months or less to live. If a patient does not have a provider to submit an order, they can contact the hospice service in their area for assistance with the process.

If the patient’s condition improves they can return to curative therapy or continue on with their daily life.

The process begins with a provider’s statement that the patient’s life expectancy is six months or less and the patient has made a decision to seek comfort care only. If the diagnosis is not cancer, the patient must meet Medicare/Medicaid criteria to have hospice services covered (most private insurance agencies use similar criteria). Finally, there must be a caregiver in place or there must be a plan to acquire one when necessary.

No. All care is intermittent, with the frequency of visits determined by your needs, your provider and hospice staff. We can provide information about services that offer this level of care, if you or your family needs help in this area. Then you can determine which agency is the best fit.

No. A hospice program can do nothing either to speed up or to slow down the dying process.

No. Our hospice services are available for patients at home, in nursing homes, retirement homes, adult family homes or anywhere the patient resides.

Hospice care coverage is provided by Medicare, Medicaid and by most private health insurance policies. Medicare and/or Medicaid are the most frequent sources of payment. Both will pay for medication relating to the terminal diagnosis, equipment needed for comfort and safety (typically a hospital bed, bedside commode and wheelchair) and the services of the hospice team.

Referral sources include medical providers, hospitals, nursing homes, assisted living facilities, friends, neighbors and patients. While a doctor’s order is not required to receive these services, a provider will need to certify that the patient has six months or less to live. If a patient does not have a provider to submit an order, they can contact the hospice service in their area for assistance with the process.

Hospice provides continuing contact and support for family and friends for at least a year following the death of a loved one. We also sponsor grief and bereavement groups.