LEVELS OF CARE:

If an individual qualifies for Hearts for hospice care, a team of doctors, nurses, home health aides, social workers, counselors and trained volunteers are available to help them and loved ones cope with their illness. Services are intermittent and through an interdisciplinary approach, a plan of care is developed and followed by the team to support the individual, caregivers and other family members. Twenty-four hour on-call services are available from skilled nursing team members.

When a referral is made to Hearts for Hospice, the admissions team, along with the individual’s attending physician and the Hearts for hospice medical director, will decide the level of care needed.

Below are the four levels of care:

Routine Care

Occurs when regularly scheduled visits are adequate in maintaining the individual’s symptom management. Care is provided at the individual’s residence.

Continuous Care

Provided to prevent the individual from going to the hospital when a crisis occurs. Continuous care also is given when more helps is needed to assist the individual and family in coping with the crisis. This level of care is usually provided at the individual’s residence no matter where that may be including residence in a long-term care facility. The criteria for continuous care may include:

• Severe pain or symptoms which are out of control
• Psychotic episodes
• Breakdown of caregiver
• Imminent death and family unable to cope

In-patient Care

Provided in a skilled nursing facility when the symptoms cannot be managed elsewhere. The skilled nursing facility must have 24-hour R.N. coverage as deemed by Medicare guidelines. General in-patient care is usually short in duration. This level of care is usually due to symptoms which are out of control and more intensive nursing services are required. If an individual is at a care facility, room and board are covered by hospice during this period.

Respite Care

Provided when the family needs time to rest or go out of town for a short time. Ideally, this service is provided for five consecutive days. Care may be provided in a long-term care facility depending on the condition of the individual. Hospice is responsible for financial arrangements with the facility.  Hearts To-Go Transportation can transport the patient to and from the respite stay.

When residing in a care setting (assisted living, skilled nursing or group home), room and board are not covered by the Medicare Part A hospice benefit. However, when an individual is eligible for and receiving general in-patient care, their room and board are covered by the Medicare Part A hospice benefit.

Hearts for Hospice also covers the following items that are directly related to the terminal diagnosis to provide comfort:

• Basic medical equipment (bed, commode, wheelchairs, walkers, etc.)
• Medical Supplies (bandages, catheters, etc.)
• Medications for symptom control and pain relief

MEDICATIONS:

The Medicare Part A hospice benefit covers all medications related to the terminal diagnosis to provide comfort. 

MEDICARE PART D:

Individuals on hospice who have Medicare Part D coverage will continue to utilize their Part D plan for medications that are not covered by hospice.