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About Hospice Care

“Hospice care” is, by its very definition, life-giving and comforting health care for people who are living with a life-limiting illness. When cure is no longer a reasonable goal, hospice care provides comprehensive medical, psychosocial, and spiritual support—addressing the needs of the “whole person,” not just the illness. It also provides support to family members and caregivers who are coping with the complex consequences of illness, disability, and impending death. The realities of loss and grief of the patient and family are addressed both during the illness and after the death.

The predominant goals of care are to help the person live with decreased pain and symptoms caused by the illness, while achieving the maximum quality of life possible—in whatever way the person defines it, for whatever time is left.

Hospice care is given by medical professionals who come to the person wherever they live – private home, nursing facility, or retirement community—or in a place of temporary residence, such as a hospital or hospice inpatient unit. A “Plan of Care” is created for the person, based on the desires and capabilities of the person and their family/caregivers, and on the input of hospice team members. Care is provided during scheduled visits and in-between visits as needed, as well as by telephone and email communication as arranged with the family. Hospice staff are available to patients and caregivers 24 hours a day, 7 days a week, 365 days a year.

For more specific and detailed information, see the categories outlined below.

Admission Criteria
• The person has an end-stage illness with a prognosis of 6 months or less to live if the disease continues its current course

• The person agrees to forego or discontinue aggressive treatments and receive comfort care

• The person has a designated attending physician, which may be a nurse practitioner, willing to work with the Hospice team

• Hospice patients are not required to have a “Do Not Resuscitate” order (DNR)

Hospice Staff
HOSPICE SERVICES are delivered by a team of medical professionals. Some services are an automatic part of hospice care; some are optional.

  • The person’s “attending physician” automatically remains a part of the team.

  • The Hospice Medical Director oversees the care of every hospice patient.

  • Nursing Services - automatic

  • Social Work Services - automatic

  • Hospice Aides - optional

  • Spiritual Counseling - optional

  • Volunteer Services - optional

  • Bereavement Services - optional

  • Other Disciplines as needed: Physical Therapy - Occupational Therapy - Speech Therapy - Dietary Counseling

  • Other Collaborative Providers as needed: Pharmacist - Durable Medical Equipment Vendor - Consulting Physicians - Hospital - Skilled or Assisted Living Facility
    • Reimbursement For Care
  • Medicare and Medicaid both have Hospice Benefits - Reimbursement is made to the hospice provider based on the level of care provided on each given day

  • Rates are established annually by Centers for Medicare & Medicaid Services (CMS)

  • Veterans Administration and most private insurance companies cover hospice care

  • Patients are accepted into service regardless of ability to pay
    • Levels of Hospice Care
    There are 4 levels of care covered by Medicare & Medicaid, the VA and some private insurance policies. The level of care is based on patient and/or family needs.

  • Routine Home Care

  • Continuous (or Crisis) Care

  • General Inpatient Care (GIP)

  • Respite Care

    • Regulatory Oversight

    There are hospice licensing rules in both North Carolina (NC Department of Health and Human Services) and South Carolina (SC Division of Health Licensing, Department of Health & Environmental Control-DHEC).

    Medicare-certified Hospice providers must meet Conditions of Participation (CoPs) from Centers for Medicare and Medicaid Services (CMS).

    Some hospices are accredited by one of 3 independent groups: Accreditation Commission for Health Care (ACHC); Community Health Accreditation Commission (CHAP); or The Joint Commission (TJC).