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What is Hospice?
Hospice is a model of health care designed to treat the whole person so they may live life fully, maintain dignity and retain personal control. This concept of care provides physical, emotional, & spiritual care to patients and their families living with a life-limiting illness. California Home Care & Hospice is an agency that provides this care in a patient's current place of residence. Care is provided in the patient's own home, an assisted living home, a skilled nursing facility or an inpatient facility (hospital).

Who uses Hospice care?
Hospice serves persons of any age with any life-limiting illness. Among the illnesses our patients have are: cancer, cardiac disease, renal disease, neurological illnesses, Lou Gehrig's disease (ALS), AIDS, cirrhosis, leukemia pulmonary disease and others.

When is the right time to seek Hospice services?
At any time during a life-limiting illness, it is appropriate to discuss all of a patient's care options, including Hospice. The earlier Hospice becomes involved the better. The patient and family will enjoy the full benefit of Hospice care if a relationship of trust between patient and Hospice can develop over several months. Delivery of quality services depends upon an understanding of the patient's and family's needs and the development of a suitable plan of care.

It is time for hospice care:

• When curative treatment is no longer an option
• When the emphasis changes to comfort, symptom control and enhancing the quality of life.
• When a physician thinks Hospice can help.
• When a patient knows they are not going to get well. Patients reach this awareness before others do.


Admission Criteria:

• Cessation of Curative Treatment
• Prognosis of Six Months or Less
• Consent of the Attending Physician

How are Hospice services initiated?
A physician (or other health care professional), a patient or designated health care surrogate may request Hospice services. Ultimately the patient and primary physician must agree that the referral is appropriate and approve an admission to Hospice. Hospice care is established when the patient, primary caregiver or health care surrogate visit with the Hospice admission team and agree to the admission terms in written form. A plan of care is established and subsequent visits by the nurse and social worker are scheduled.

What are the services I may receive from Hospice?
The specific services offered by Hospice include registered nurses, medical social workers, home health aides, dietitian, therapists (physical, occupational, speech & respiratory), volunteers, chaplain, and grief counselors. An on-call RN is available for emergent needs on a 24-hour basis. Medical supplies/equipment, medications, inpatient care and respite care are provided in accordance with Medicare or the patient's insurance provider.

What is the service area for California Home Care & Hospice, Inc.?
CHCH covers approximately a 50 mile radius within the California Central Valley. To see a list of the cities/towns we serve, please Click Here.

Can a Hospice patient continue with his or her own physician?
Yes. The Hospice medical director will review the Hospice plan of care and is available to consult with the primary physician if needed. Hospice nurses will work with the patient's doctor on all aspects of care.

Does Hospice provide 24-hour nursing?
No. Hospice nurses visit weekly or more frequently as the patient's condition dictates. A Hospice nurse is also accessible 24 hours a day by phone to assist with questions or emergencies and will make a home visit if needed. During a crisis, a nurse will stay with the patient until the crisis is resolved.

Who pays for Hospice care?
What is the Hospice Medicare Benefit?
The Hospice Medicare Benefit is an additional benefit provided by Medicare under Medicare part A.

The Hospice provider is paid a daily rate by Medicare to provide the following services:

• Primary RN to provide pain and symptom management.
• On-call RN for emergent needs after normal working hours, weekends, & holidays.
• Primary Social Worker to provide emotional support, address financial concerns, acts as an advocate, initiate community resources and meet counseling needs.
• Home Health Aide for personal hygiene, or light housekeeping.
• Dietitian for dietary counseling.
• Therapists (Physical, Occupational, Speech & repiratory).


Additional benefits provided when related to the Hospice illness and necessary to provide comfort:

• Medications that are related to the Hospice diagnosis or provide pain and symptom management.
• Durable medical equipment, oxygen, and disposable medical supplies.
• Consulting physician services.
• Laboratory and diagnostic procedures that will assist in providing adequate pain and symptom management.
• Medical Transportation
• Palliative procedures and/or treatments that provide pain and/or symptom management.
• General inpatient care/hospitalization related to hospice diagnosis.
• Inpatient respite care.
• Continuous care to manage a crisis situation where symptoms are out of control.

The Hospice Medicare Benefit is an exclusive benefit elected by the patient or legal representative to provide for all of the necessary palliative care related to the illness. While a patient receives care under the Hospice Medicare Benefit, other providers cannot bill Medicare for services or items related to the care and treatment of the Hospice diagnosis. Medical needs and preexisting conditions unrelated to the Hospice diagnosis are covered under Medicare Part A or B as normal and customary whichever is appropriate.

Under what circumstances would a patient be discharged from Hospice?

• A patient (or health care surrogate) may request discharge for any reason.
• A remission or long-term stability of the Hospice illness is achieved.
• The patient leaves the service area.
• The patient seeks treatment outside the Hospice plan of care.
• A plan for safety for the patient or the Hospice staff cannot be instituted.

Does Hospice provide any support to the family after the patient dies?
If desired Hospice will provide continuing contact and support for caregivers and/or families for at least a year following the death of a loved one. This is called the Bereavement Program. Bereavement counselors will offer support to meet the needs of those who are grieving. Support may be in the form of grief education, support groups, one-to-one counseling, phone calls or written communication.

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