Verde Valley Community Hospice
Hospice Care
Hospice: A Philosophy of Care
Hospice is a specialized treatment option that offers a full range of physical, emotional, spiritual and social services to people with limited life expectancy, and to their loved ones. When medical treatments cannot cure a disease, Verde Valley Community Hospice care is a shift in focus from managing doctor appointments and scheduling treatments to choosing care to make life as comfortable, enjoyable and meaningful as possible. Comfort care includes having pain and symptoms aggressively managed by a compassionate team of clinical experts trained to care for persons dealing with end-of-life issues. Because hospice is a philosophy of care, not a place, it comes to where you are. Our hospice team members serve as teachers, enabling family to care for their loved one at home, if that is their desire. Verde Valley Community Hospice’s supportive team approach focuses on comfort, dignity and quality of life. This approach is designed to embrace life in all of its facets – body, mind and spirit - and help beneficiaries, families and friends cope with the physical, emotional, spiritual and social aspects that arise during the difficult time.  


Who is Eligible for Services?
An individual is eligible for hospice care when there is a life-limiting illness not responding to curative treatment, or when the patient and family no longer desires curative treatment. Care is provided regardless of diagnoses, age, gender, nationality, race, creed, sexual orientation, disability or ability to pay. To qualify, the person seeking admission must have a physician certify that life expectancy is six months or less. The time frame is flexible and services can be extended beyond this period in some cases. Financial coverage is available through the Hospice Medicare Benefit, and most private insurance companies. No person shall be denied service regardless of ability to pay.


When to Consider Calling Verde Valley Community Hospice
For some living with a life-limiting illness, there comes a point when a cure is no longer possible. Unfortunately, many people wait until their final days to involve hospice. While the possibility of a cure is gone that does not mean all hope must be abandoned. With the support of the Verde Valley Community Hospice’s team, hope is redefined. There is still hope for peaceful remaining time left; hope to spend days free of pain; and hope in spending quality time with loved ones in the familiar surroundings of home. Consider these questions, when weighing your options:
  • Has the disease progressed to a point that there is no cure, and a decision has been made to manage the pain and focus on the quality of life?
  • Does treatment have more complicating factors than relief-producing factors?
  • Have hospitalizations or emergency room visits increased and become too overwhelming and frequent?
  • Is valuable time spent sitting in the chair of waiting rooms in a doctor's office?
  • Have infections and falls increased, or is the individual becoming weaker and losing physical ability?
  • Has the individual experienced unexplained weight loss, or many illnesses or physical problems at the same time?
  • Is the family caregiver worn down, needs support and can’t do it alone anymore?
By contacting hospice when the disease is chronic and treatment is becoming burdensome or is no longer an option, the beneficiary and family are given the gift of time to understand their options and choose the path that will have the most positive impact on the quality of life. The best time to learn about hospice is before it is needed.

Patient Rights
  • Right to exercise these rights as a patient of hospice.
  • Right to have property and person treated with respect, dignity and consideration.
  • Right to voice grievances about treatment of care or lack of respect for property by anyone who is providing hospice services.
  • Right not to be subjected to discrimination or reprisal for exercising your rights.
  • Right to appropriate and compassionate care without discrimination.
  • Right to receive effective pain and symptom management related to this condition.
  • Right to choose your own physician.
  • Right to be free of mistreatment or inappropriate treatment (verbal, mental, sexual and physical abuse).
  • Right to be informed of the hospice philosophy, admission criteria, services to be provided, options of care available and any charges which may be incurred.
  • Right to participate in developing your Plan of Care.
  • Right to expect confidentiality.
  • Right to be involved in decisions about care, treatment and services.
  • Right to receive effective communication regarding your care.
  • Right to refuse services or withdraw from the program at any time.
  • Right to be photographed with your consent.
  • Right to refuse to participate in research or experimental programs.
Patient/Family Responsibilities
  • Provide accurate and complete information, which is used to help hospice deliver appropriate care.
  • Ask questions when you do not understand your care, treatment and services.
  • Remain under a physician’s care while on hospice.
  • Assist hospice staff in developing and maintaining a safe environment.

Verde Valley Community Hospice Responsibilities

  • Provide quality care without discrimination.
  • Provide professional staff and volunteers to care for you and your family.
  • Provide care which is ethical, in the best interest of the patient and is respectful of your life values, religious and cultural, personal preferences.
  • Provide verbal and written notice of the rights and responsibilities in appropriate language.
  • Inform and distribute written information to you concerning policies on advance directives (DNR, Living Will, and Medical Power of Attorney).
  • Ensure that all alleged violations involving inappropriate treatment or mistreatment by anyone furnishing hospice services are reported immediately by the hospice employees and contracted staff to the hospice administrator.
  • Immediately investigate all alleged violations, take immediate action to prevent further potential violations while an investigation is being conducted.
  • Take appropriate corrective action in accordance with state law if the alleged violation is verified.
  • Ensure that verified violations are reported to appropriate jurisdiction within five working days of becoming aware of the violation.

Who Pays for Hospice?
Hospice is covered by Medicare and most insurance plans, with no out-of-pocket costs for the patient/family. The Medicare hospice benefit covers costs related to the terminal illness, including the services of the hospice team (nurses, medical social workers/counselors, certified nursing assistants and chaplains), medication, medical equipment and supplies. Medicare reimburses for different levels of hospice care recognizing some individuals require special attention.

Medications:
The Medicare hospice benefit covers medications that are associated with the diagnosis and needed to treat the person’s terminal illness. Verde Valley Community Hospice will order the medications for the patient and medications are delivered by the pharmacy to their door. Medications for any condition not related to the terminal illness — allergy medication, for example — are not covered by the hospice benefit.

Medical supplies: The physician and hospice nurse will work with the individual and family to determine which durable medical equipment and biological supplies are needed. These can include equipment like hospital beds, bathroom safety equipment, oxygen and biological supplies like briefs, wound care, etc. Items covered under the Medicare benefit must be related to the hospice diagnosis.

Hospice care does not automatically end after six months. Medicare and most other insurers will continue to pay for hospice care as long as the patient continues to meet eligibility criteria and the physician supports that the patient continues to have a limited life expectancy. Occasionally, the quality of care provided by Verde Valley Community Hospice leads to substantially improved health. When this happens, Verde Valley Community Hospice will transfer care to the patient’s primary care physician. Later, if the individual becomes eligible for hospice, they can re-elect the hospice benefit. There is no penalty for getting better!

Identifying Hospice Appropriate Referrals

A referral to Verde Valley Community Hospice can be made by anyone: a family member, friend, nurse, physician or even the individual who is seeking more information about hospice and palliative care.  All you need to do is call the Verde Valley Community Hospice office 928.634.1073. Upon receiving the referral, a member of the Hospice Admission Team will contact the referral.  In summary, four things are necessary to complete an admission:

  1. Verde Valley Community Hospice Admission Team meets with the patient/family to explain the hospice benefit.
  2. The patient meets Medicare eligibility criteria.
  3. The patient/family agrees with hospice care and the hospice philosophy.
  4. The Primary Care Physician or Verde Valley Community Hospice Medical Director agrees that hospice services are appropriate and thus orders hospice care

Our goal is to meet with the patient/family within 2-4 hours of receiving the information. The Hospice Team is available to answer questions regarding when a referral is appropriate. When you call the hospice office with a referral, some information will help with the process:

  • Your name
  • Name of the patient
  • Patient contact phone number
  • Date of birth and social security number
  • Patient’s primary physician’s name and phone number
  • Caregiver’s name and contact number

Download a Referral Form

 

Who Qualifies for Hospice Care?

Any disease process can qualify, and it is the responsibility of the Verde Valley Community Hospice Admission Team to determine eligibility. Various disease processes are eligible including, though not limited to:

  • ALS
  • Alzheimer’s (Dementia Type)
  • Cardiac
  • Cancer
  • Coma
  • Heart Disease
  • HIV
  • Renal Failure (Acute)
  • Renal Failure (Chronic)
  • Respiratory disease (COPD)
  • Neurological disease (Parkinson’s)
  • End-stage dementia
  • End-stage Kidney disease
  • End-stage liver disease
  • Decline in clinical status (Previously Failure to Thrive or Debility)
  • Stroke (Cerebral Vascular Disease)

General Criteria for Eligibility, along with disease specific criteria, includes a variety of evaluation methods facilitated by the Hospice Admission Team. The Team considers a wide variety of factors including, though not limited to:

  • One must have a life-limiting disease process (approximately 6 months or less if the disease process follows its normal course without medical intervention)
  • A checklist is used for determining functional performance (Palliative Performance Scale)
  • Fall Risk Evaluations
  • Daily functional limitations
  • Symptoms and changes in symptoms in the past 6 months
  • Changes in lifestyle over last 6 months
  • Frequent trips to Hospital, ER and/or MD office

 

General and Specific Evaluation Tools/Criteria Utilized by Hospice Admission Team

Palliative Performance Scale measures:

  • Activity level as evidenced by the disease
  • Range of self-care
  • Ability to ambulate
  • Food/fluid intake
  • Level of consciousness

Fall Risk:

  • History of falls
  • Mental status changes
  • Lower extremity weakness or unsteady gait
  • Medications (two or more of the following-Diuretics, Laxatives, Narcotics, Psychotropic, Sedatives, Anti-seizure)
  • Alternation in bowel and bladder function
  • Sensory deficits: Alternation in hearing, eyesight

Functional Limitations and Supportive Symptoms

  • Weight loss over last 6 months
  • Appetite loss
  • Loss of ability to feed self
  • Severe weakness
  • Loss of ability to bath, dress, take medication, prepare meals, ambulate or toilet
  • Increasing levels of fatigue
  • Mobility problems, reliance upon assistive devices, such as cane, walker, or wheelchair (may be bedridden)
  • Recurrent infections
  • Development of Stage III or IV decubitus ulcers (pressure sores)
Who Pays for Hospice?

Hospice is covered by Medicare and most insurance plans, with no put-of-pocket costs for the patient/family.

The Medicare hospice benefit covers costs related to the terminal illness, including the service of the hospice team (nurses, medical social workers/counselors, certified nursing assistants and chaplains), medication, medical equipment and supplies.  Medicare reimburses for different levels of hospice care recognizing some individuals require special attention.

  • Medication: The Medicare hospice benefit covers medications that are associated with diagnosis and needed to treat the person’s terminal illness. Verde Valley Community Hospice will order the medications for the patient and medications are delivered by the pharmacy to their door. Medications for a condition not related to the terminal illness-allergy medication, for example-are not covered by the hospice benefit.

 

  • Medical Supplies: The physician and hospice nurse will work together with the individual and family to determine which durable medical equipment and biological supplies are needed. These can include equipment like hospital bed, bathroom safety equipment, oxygen and biological supplies like briefs, wound care, etc. Items covered under the Medicare benefit must be related to the hospice diagnosis.

 

Important Notes:

Hospice care does not automatically end after six months. Medicare and most other insurers will continue to pay for the hospice care as long as the patient continues to meet eligibility criteria and the physician supports that the patient continues to have a limited life expectancy.

Occasionally, the quality of care provided by Verde Valley Community Hospice leads to substantially improved health. When this happens, Verde Valley Community Hospice will transfer care to the patient’s primary care physician. Later, if the individual becomes eligible for hospice, they can re-elect the hospice benefit. There is no penalty for getting better!