Hospice care focuses on quality of life for people diagnosed with terminal illnesses by providing them with superior pain and symptom management and professional support for their families.
When is hospice care right for my patient?
To be eligible for hospice care, your patient must have a life expectancy of six months or less if the disease runs its natural course. When curative treatment is no longer effective for your patient’s terminal illness or isn’t adding to quality of life, hospice care is an option.
There are guidelines and scales that help determine a patient’s current clinical status and anticipated disease progression that most likely will result in a life expectancy of six months: the CMS-issued hospice eligibility guidelines, Local Coverage Determination (LCD); FAST Scale; Palliative Performance Scale; and Karnofsky Performance Status.
Our professional staff are experts at understanding how these guidelines apply to each unique person and medical situation. We’ll help you evaluate your patient to determine if it’s time for hospice care. For an MD consult, or if you have someone under your care you believe might qualify for our services, call us at 866-234-7742. We’re here to take your call 24 hours a day.
Will I still be involved if I refer my patient to hospice?
Yes, attending physicians are encouraged to continue their relationships with their patients. You’re an integral part of your patient’s care team that includes The Washington Home & Community Hospices’ Medical Director and professional staff (RN’s, social workers, certified nursing assistants, chaplains and trained volunteers). You’re consulted about your patient’s care and pain/symptom management and kept updated on your patient’s status.
Am I reimbursed for my continuing services while my patient’s receiving hospice care?
Yes, as the attending physician of a hospice patient, you can be reimbursed for your patient visits under Medicare Part B as well as for the documented time you spend on Plan of Care oversight. Our finance manager can help your staff prepare Medicare reimbursement claims.
What services does The Washington Home & Community Hospices provide?
Most hospices are Medicare certified and must follow Medicare rules and regulations. There are hospice core services that must be provided directly by hospice employees on a routine basis (required by the Centers for Medicare & Medicaid Services - CMS). The core services that every hospice must provide include:
nursing services (routinely available and/or on call on a 24-hour basis, 7 days a week) provided by or under the supervision of a registered nurse (RN) functioning within a plan of care developed by the hospice in consultation with the patient’s attending physician (if the patient has one)
medical social services by a qualified social worker under the direction of a physician
counseling (including but not limited to, bereavement, dietary, and spiritual counseling)
Bereavement services are available to the family and other individuals identified in the bereavement plan of care for up to one year following the death of the patient.
Compare our services to other hospices to make sure that you select the hospice that’s a good match for your patient.
The Washington Home & Community Hospices provides:
Medicare-certified comfort care wherever your patient calls home
all medications, equipment and supplies needed for comfort
credentialed and certified medical director who works with the patient’s attending physician credentialed and certified nurses and social workers
regular visits from a registered nurse to manage pain and symptoms
round-the-clock phone support from a registered nurse for pain management
personal care from a certified nursing assistant
a social worker and chaplain to help with end-of-life planning and ease emotional and spiritual anxiety
regular breaks for caregivers covered by trained hospice volunteers
access to inpatient care at a partner facility
access to respite care at a contracted facility
a Hospice Caregiver’s Relief Program that provides free homecare aides for hospice patients whose caregivers must work or are frail and elderly (a charity initiative for families who qualify)
Hospice Doula and 11th Hour Programs for patients who need comforting companionship
We Honor Veterans Program that focuses on the unique end-of-life needs of the women and men who’ve served our country.
“What if I told you that this organization would send well trained
nurses to see your patient, aides to lend a hand with daily care,
a social worker to help the family grapple with the emotional difficulties?
That these folks would deliver equipment your patient might need –
a hospital bed, say, or wheelchair – and all your [patient’s drugs]?
What if they’d also send a chaplain if you wanted one?
And provide a nurse to call 24/7 when you had questions or problems?
And volunteers who would stay with your [patient] while you took a
few hours break, even if just for a long, quiet walk?
And what if I told you that all this would cost [your patient] nothing,
that Medicare would pay for it all?
You’d pick up the phone, right?”
(Paraphrasing “Avoiding the Call to Hospice,” Paula Span, The New York Times)
What if my patient needs more care than s/he can get at home?
Your patient is admitted to hospice care at one of the following levels depending on your patient’s needs:
Routine Home Care – we come to where your patient is and control pain and symptoms with medications, medical equipment and visits from our Registered Nurses. Our staff visit as often as they and you – the primary care doctor - determine your patient should be seen. A hospice nurse is available 24/7.
Inpatient Care – we care for your patient in one of our nearby partnering inpatient facilities, if her/his pain and symptoms can’t be managed well at home. Inpatient hospice care provides 24/7 on-site RN’s and aides, working with our team. Their goal is to get pain and symptoms under control so that your patient can return home.
Continuous Nursing Care – we come to your patient’s home when her/his pain and symptoms can’t be managed well there but s/he doesn’t want to go to an inpatient unit. An RN and an aide provide coordinated coverage for at least eight (8) hours daily for a brief period of time. This care is provided under most insurance plans.
Respite Care – if requested, The Washington Home & Community Hospices contracts with a facility where your patient stays for up to five (5) nights while her/his caregiver gets some much-needed time and rest. Then your patient returns to routine hospice care at home.
How do I talk about hospice with my patient and the family?
Most patients with terminal illnesses depend on their physicians to initiate discussions about their healthcare status and options but navigating end-of-life conversations is difficult for most physicians whose focus is on sustaining life. The Washington Home & Community Hospices’ end-of-life experts come to your office to offer you insight and recommendations for talking with your patient.
Another resource, Dr. Richard B. Balaban’s excellent article, “A Physician’s Guide to Talking About End-of-Life Care” (Journal of General Internal Medicine), provides a four-step approach to addressing end-of-life issues with useful scripts from faculty clinicians experienced in the care of dying patients.
For example, Step 1 Initiating Discussions, suggests dialogue that creates a caring connection by recognizing the stresses that serious illness creates for your patient and family:
“I know this is a very difficult time for you and your family.
You have never been this sick before, and I know that it
must be frightening to you. I want you to know that as
bad as it is, we will deal with it together.”
How do I refer my patient to The Washington Home & Community Hospices?
We make it as simple as possible for you:
Call 866-234-7742 between 8:30 – 5:00 Monday through Friday and someone speaks with you within two hours. Call after business hours, someone returns your call as soon as possible; or,
FAX Referral Form to 202-895-0154 and someone will contact you as soon as possible.