Frequently Asked Questions
- What can we expect from the Hospice of the Sacred Heart staff?
- When is hospice appropriate?
- Should I wait for our physician to bring up the subject of hospice or can I ask about it first?
- What if our physician doesn’t know about hospice?
- When should a decision about entering a hospice program be made and who should make it?
- Where do I go to receive hospice care?
- Is it true that hospice is where you go when there is “nothing else to be done”?
- What if I don’t understand what is happening and don’t know how to make the right decisions?
- What does the admission process involve?
- How do I refer someone to Hospice of the Sacred Heart?
- Can I keep my regular doctor?
- Who pays for hospice services?
- If the patient is eligible for Medicare, will there be any additional expenses to be paid?
- Do I lose any Medicare benefits because I am on Medicare hospice care?
- Are you a for-profit or a non-profit agency?
- What if I do not have Medicare, Medicaid or private insurance or enough personal income to pay for services?
- When does hospice care stop?
- Can a Hospice of the Sacred Heart patient who shows signs of recovery be returned to regular medical treatment?
- What if the patient wants to transfer to a different hospice agency?
- Is there any special equipment or changes I have to make in my home before hospice care begins?
- How many family members or friends does it take to care for a patient at home?
- How difficult is caring for a dying loved one at home?
- What if we have a problem on a weeknight, weekend or holiday?
- Does Hospice of the Sacred Heart do anything to make death come sooner?
- How does Hospice of the Sacred Heart manage pain?
- Will medications prevent the patient from being able to talk or know what is happening?
- Does Hospice of the Sacred Heart provide any help to the family after the patient dies?
- Is Hospice of the Sacred Heart affiliated with any religious organization, other hospice, nursing home or assisted living facility?
- Is hospice care more expensive than regular care?
- How does Hospice of the Sacred Heart use and/or disclose my personal health care information?
1. What can we expect from the Hospice of the Sacred Heart staff?
Our interdisciplinary team is made up of very experienced health care professionals and volunteers. Each is highly skilled and specially trained to meet the needs of the terminally ill and their families.
The team is headed by our hospice Medical Directors who, together with the patient, his/her family and primary physician, determine the patient’s eligibility for hospice. The Medical Directors consult with the patient’s primary physician and the interdisciplinary team to develop the patient plan-of-care. With the help of the hospice team, the Medical Directors also monitor the patient’s condition and prescribe palliative medications as needed to ensure that the patient is comfortable.
Our Registered Nurse Case Managers make regularly scheduled visits to the patient to provide expert pain management and symptom control. The Case Manager provides education to the primary caregivers and patient so that care is provided properly and safely. The Case Manager also keeps the primary physician and our Medical Director informed about the patient’s condition. Support from our Registered Nurses is available, as needed, on a 24/7/365 basis.
Social Workers provide assistance with practical and financial concerns as well as emotional support, counseling and bereavement follow-up. They evaluate the need for volunteers and other support services needed by the family and facilitate communication between the family and community agencies.
Chaplains provide non-denominational spiritual support to patients and families, often serving as a liaison between them and their religious community. They offer support services ranging from crisis help to private and group grief support. Chaplains also often assist with memorial services and funeral arrangements.
Our nursing staff provides personal care and assistance with activities of daily living, feeding and bathing and hands-on care. They also perform limited household services to maintain a safe and sanitary environment in the areas of the home used by the patient.
Trained volunteers provide a number of important services. Volunteers offer direct patient support, companionship and practical, caring help. Volunteers can assist the primary caregivers by sitting with the patient to provide the caregivers respite from the sometimes overwhelming task of providing around the clock care for a loved one. Volunteers may also provide non-direct patient support by assisting the agency in its office and clerical work.
Finally, the most important thing you can expect from the Hospice of the Sacred Heart staff is an aggressive, passionate belief in, and adherence to, our philosophy of hospice patient care.
2. When is hospice appropriate?
Hospice care becomes an appropriate method of care when a patient has reached the last phase of a life-limiting illness or condition. The subject of hospice care can be addressed at any time as the physician and patient discuss treatment options.
When a patient chooses hospice, the decision is made to give up curative measures in favor of comfort care that focuses on pain management and symptom control, as well as emotional and psychosocial support for both patient and family.
3. Should I wait for our physician to bring up the subject of hospice or can I ask about it first?
The decision to choose hospice should be made by patient and family with the input of a physician. Open and honest discussions about treatment options should be held throughout the course of the illness. If a patient or family feels that a physician is reluctant to discuss hospice care, it is always appropriate for one or the other to approach the subject. If there is a question you need answered, please call Hospice of the Sacred Heart at anytime.
4. What if our physician doesn’t know about hospice?
Most physicians know about hospice. However, if your physician would like more information, he or she may call us at (570) 706-2400 or email us at firstname.lastname@example.org
5. When should a decision about entering a hospice program be made and who should make it?
At any time during a life-limiting illness or condition, it is appropriate to discuss all of a patient’s care options, including hospice. By law, the decision regarding hospice care belongs to the patient.
There is no definite time because each patient/family situation is different; however, Medicare studies and our own experiences have shown that early referrals are very beneficial for the patient both physically and emotionally. Hospice care should be considered when the patient enters the final stage of life and the patient/caregiver/family need help and counseling to adjust to the diagnosis, learn how to care for the patient at home and prepare for future changes.
Understandably, most people are uncomfortable with the idea of stopping an all-out effort to overcome an illness or condition. Hospice of the Sacred Heart staff members are highly sensitive to these concerns and are always available to discuss them with the patient, family and physician.
We would like to take this opportunity to clear up a misconception regarding the Medicare Hospice Benefit. Unfortunately, many people believe the use of the Medicare Hospice Benefit somehow guarantees that the patient has less than six months to live. We offer the following explanation and clarification from Medicare regarding its hospice benefit program.
“Generally speaking, the hospice benefit is intended primarily for use by patients whose prognosis is terminal, with six months or less life expectancy. [However], the Medicare program recognizes that terminal illnesses do not have entirely predictable courses.”
“Recognizing that prognoses can be unpredictable and may change, Medicare’s benefit is not limited in terms of time. Hospice care is available as long as the patient’s prognosis meets the law’s six month test. This test is a general one… based on the physician’s and/or Medical Director’s clinical judgment regarding the normal course of the individual’s illness. Medicare recognizes that making medical prognostications of life expectancy is not always an exact science.”
6. Where do I go to get hospice care?
Hospice of the Sacred Heart provides the majority of its care in a patient’s home, with family and friends acting as caregivers. If the patient no longer lives at home, we can provide care in nursing homes, assisted living facilities, or other types of assisted living facilities. If a patient requires inpatient care in order to address severe symptoms or to provide respite for a caregiver, we will arrange that for the patient. There is no charge to the Medicare patient for inpatient care.
7. Is it true that hospice is where you go when there is “nothing else to be done”?
Hospice is the “something else” that can be done for the patient and family when the illness or condition becomes life-limiting. It is a concept based on comfort-oriented care. Referral to hospice is a movement into another mode of care, which is more appropriate.
8. What if I don’t understand what is happening and don’t know how to make the right decisions?
Hospice of the Sacred Heart provides patients and families the information and education they need to make informed decisions about hospice and the patient’s plan-of-care. Our Links to Information Resources on this website would be a good place to begin your research. The patient and family should also consult with the patient’s physician and the members of the Hospice Interdisciplinary Team to ensure that all questions are answered and all concerns are discussed.
9. What does the admission process involve?
A phone call to Hospice of the Sacred Heart at (570) 706-2400 is all that you need to do to start the admission process.
One of the first things we will do is contact the patient’s physician to make sure the physician agrees that hospice care is appropriate for the patient. One of our Registered Nurses will then visit the prospective patient and family to ask important questions about the illness and previous treatment, as well as questions about the home and family situation that would affect care giving.
The nurse will explain what the patient and family can expect from the hospice, how hospice provides care, the services that are available and information on the illness or condition that will help prepare the family for the journey. Medicare and/or other available benefits also will be discussed at that time.
10. How do I refer someone to Hospice of the Sacred Heart?
A referral can come from the attending physician, a family member, a friend, clergy, a health care provider or even from the patient. You only need to call our office at (570) 706-2400 to provide your referral.
11. Can I keep my own doctor?
Yes. If that is your desire, your doctor will continue as your primary physician and will approve your admission to hospice care, delivery of services to you and changes in your plan-of-care. The hospice team members will work closely with your doctor in administering and providing your care.
However, you and your doctor may also elect to have our Medical Director assume primary responsibility for your hospice care, since Hospice Medical Directors have extensive experience and expertise in the full spectrum of hospice and palliative care. In either case, Hospice of the Sacred Heart functions as an extension of, not in place of, your primary physician. Even if our Medical Director has primary responsibility for your care, your physician will always be given updates on your status and the status of your care. Your physician also will continue to provide non-hospice related services to you and will be able to continue billing Medicare for the non-hospice related services he provides.
Our Medical Director is also available to help patients who do not have a primary physician.
12. Who pays for hospice services?
Hospice care coverage is widely available. Hospice of the Sacred Heart is a state licensed and Medicare/Medicaid provider. For those eligible for Medicare Part A benefits, all hospice care costs are covered. Many private insurance carriers pay 80% to 100% of hospice charges up to a pre-determined limit. To be sure of private insurance coverage, families should, of course, check with their employer or health insurance provider. In some cases, the patient may elect to pay for services directly. Hospice of the Sacred Heart will never deny hospice services based on patients ability to pay.
13. If the patient is eligible for Medicare, will there be any additional expenses to be paid?
Medicare/Medicaid covers all services and supplies related to the terminal illness or condition for the hospice patient. Hospice of the Sacred Heart NEVER asks for any payment of any kind from its Medicare/Medicaid patients.
14. Do I lose any Medicare benefits because I am on hospice care?
If you are using your Medicare Hospice Benefit, it is important to understand that the hospice agency only uses that portion of your Medicare Part A benefit (hospitalization) related to the medical diagnosis or condition that qualified you to receive hospice care. The remaining portion of your Medicare Part A benefit and all of your Part B benefit (physician visits) continue to be available for your use. You will still be able to consult with your physician on any issues relative to your medical care that does not involve the diagnosis or condition that made you eligible to receive hospice care. Your physician also will be able to continue billing Medicare/Medicaid for services he/she provides.
15. Are you a for profit or non-profit agency?
Hospice of the Sacred Heart is a non-profit agency, charitable trust within the state of Pennsylvania.
16. What if I do not have Medicare, Medicaid or private insurance or enough personal income to pay for services?
Hospice of the Sacred Heart does not discriminate on any patient’s ability to pay.
17. When does hospice care stop?
Hospice care is provided as long as the patient continues to meet the Medicare, Medicaid or private insurance enrollment criteria and desires to have hospice care.
We also provide bereavement care for the family after the patient dies. Medicare requires hospice agencies to provide twelve months of bereavement. Hospice of the Sacred Heart provides bereavement care as long as required, without regard for any time limit.
It is important to understand that a Medicare certified hospice agency cannot terminate a patient’s Medicare Hospice Benefit unless one of the following conditions (listed in the Medicare Conditions of Participation) occurs. These conditions are the ONLY conditions that can terminate Medicare funded hospice care.
- The patient moves out of the hospice agency’s service area or decides to transfer to another hospice
- The patient makes the decision to resume curative treatment. In this case, the patient may revoke hospice care and the patient immediately resumes his/her regular Medicare coverage. The patient may, at any time, return to hospice care by re-enrolling with Hospice of the Sacred Heart or another hospice provider
- The patient is no longer eligible for hospice care, as determined by the patient’s primary physician and our Medical Director
- The patient’s (or other persons in the patient’s home) behavior is disruptive, abusive or uncooperative to the extent that delivery of care to the patient or the ability of the hospice to operate effectively is seriously impaired. The hospice agency must do the following before it seeks to discharge a patient for cause:
- Advise the patient (or patient’s representative, if patient is unable to make decisions) that a discharge for cause is being considered
- Make a serious effort to resolve the problem(s) presented by the patient’s behavior or situation
- Ascertain that the patient’s proposed discharge is not due to the patient’s use of necessary hospice services
- Document the problem(s) and efforts made to resolve the problem(s) and enter this documentation into the patient’s medical records maintained by the hospice agency
18. Can a Hospice of the Sacred Heart patient who shows signs of recovery be returned to regular medical treatment?
Certainly. The patient always has this option. If improvement in the condition occurs and the disease seems to be in remission, the patient can be discharged voluntarily from hospice and return to aggressive therapy or go on about his or her daily life. If a discharged patient should later need to return to hospice care, Medicare/Medicaid and most private insurance companies will allow the patient’s remaining benefit to be used.
19. What if a Medicare hospice patient wants to transfer to a different hospice agency?
The Medicare hospice patient has the right to transfer from one hospice agency to another once during EACH benefit period without loss of any Medicare Hospice Benefits. Should a patient decide to transfer a second time during a benefit period, he or she would forfeit the remainder of the current benefit period. However, since the Medicare benefit includes an unlimited number of 60-day periods, the patient would not forfeit his or her total remaining hospice benefit.
The transfer process is very simple, requiring only that the patient or the patient’s legal representative write a letter to each hospice agency. The letters need only indicate that the transfer is taking place and the date of the transfer. The letter to the previous agency should also contain a request that the patient’s records be transferred to the new hospice agency. Most agencies have transfer forms available that make the process even easier. The two agencies will then coordinate to ensure that the transfer is completed smoothly and safely.
20. Is there any special equipment or changes I have to make in my home before hospice care begins?
Hospice of the Sacred Heart will assess your needs, recommend any necessary equipment and help make arrangements to obtain it. Required medical equipment is included at no charge as part of our service to you.
21. How many family members or friends does it take to care for a patient at home?
There is no set number. One of the first things that Hospice of the Sacred Heart will do is prepare an individualized care plan that will meet the needs and goals of the patient and family. Our staff members visit regularly and are always accessible to answer questions and provide support.
22. How difficult is caring for a dying loved one at home?
It is never easy and sometimes can be quite hard. At the end of a long, progressive illness, nights especially can be very long, lonely and difficult. Hospice of the Sacred Heart has staff available around the clock to consult with the family and to make night visits when appropriate.
23. What if we have a problem on a week night, weekend or holiday?
Help from the Hospice of the Sacred Heart team is available on a 24/7/365 basis. We have Registered Nurses on call to resolve concerns by telephone, or if necessary, with a visit. We are always there for the patient, the caregivers and the family.
24. Does Hospice of the Sacred Heart do anything to make death come sooner?
Hospice of the Sacred Heart does nothing either to speed up or slow down the dying process. Just as doctors and nurses lend support and expertise during the time of childbirth, so hospice provides its presence and specialized knowledge during the normal progression of the dying process.
25. How does Hospice of the Sacred Heart manage pain?
Our Registered Nurses and Doctors are highly experienced in hospice and palliative care. They work diligently to remain current on the latest and most effective medications and devices for pain and symptom relief. We also believe that emotional and spiritual pains are just as real and in need of attention as physical pain, so we address these as well. Counselors, including pastoral counselors, are available to assist family members as well as patients.
26. Will medications prevent the patient from being able to talk or know what is happening?
It is our goal to help patients be as comfortable and alert as they desire. By constantly consulting with the patient, caregivers and family, Hospice of the Sacred Heart has been very successful in reaching this goal.
27. Does Hospice of the Sacred Heart provide any help to the family after the patient dies?
The Medicare Hospice Benefit provides bereavement support for family members and loved ones for a period of 12 months. We provide continuing contact and bereavement support to family members and loved ones, as long they need us.
28. Is Hospice of the Sacred Heart affiliated with any religious organization or other hospice?
We are a non-profit agency. We serve the entire community and do not ask or expect patients to adhere to any particular religion or set of beliefs. We accept patients without regard for diagnosis age, disability, race, color, creed, sex or sexual preference or ability to pay.
29. Is hospice care more expensive than regular care?
Studies have shown that hospice care is no more expensive than regular care. Frequently it is less expensive than conventional care during the last six months of life. Comfort care is provided rather than curative care and family, friends and volunteers provide 90% of the day-to-day care at home. If the patient has Medicare Part A benefit coverage, the Medicare Hospice Benefit, including medications, medical supplies and medical equipment, is provided at no cost.
30. How does Hospice of the Sacred Heart use and/or disclose my personal health care information?
Hospice of the Sacred Heart maintains privacy protection and adheres to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). More information on this can be found in the Notice of Privacy Practices.