Hospice Services

How to initiate hospice care/referral process

When Is It The Right Time To Contact Hospice?

Hospice care is a highly specialized form of care designed to help anyone with a life-limiting illness make the most of their final months. It combines pain and symptom management with emotional and spiritual support to help patients live the remainder of their life in comfort and dignity, surrounded by those they love. Our services include the following:

Coordination of care with patient's primary physician
Regularly scheduled RN visits
On-call RN nights and weekends
Hospice Aide assistance
Social work support
Spiritual support
Volunteer support
Bereavement support
Respite care
Durable medical equipment
Provision of personal care supplies
Provision of medications relating to the terminal diagnosis

The Typical Referral Process

You do not need a doctor’s referral to begin hospice care. Anyone can begin the process – the patient, a family member, friend, clergy – can call hospice with the initial inquiry. We can reach out to your physician and assist with obtaining the necessary paperwork.

Step 1: Determine Eligibility

Hospice care is typically for patients with a life-limiting illness, generally with a prognosis of six months or less to live if the illness follows its normal course. A doctor must certify the patient as eligible for hospice. Your doctor, if you have one, along with the hospice doctor determine hospice eligibility. If you do not have a doctor, you can still choose hospice care and the hospice doctor will determine eligibility.

Step 2: Speak With Your Doctor

Once you and your provider have determined curative care is no longer effective, or you would like to stop treatment for a terminal illness, you can choose to receive hospice care instead. Often at this time your primary care provider or specialist will initiate a referral to hospice. If you do not have a provider to initiate a referral, contact our office and we will work to obtain necessary information to begin hospice services, if eligible.

Step 3: Meet With Hospice Staff

Once a referral is initiated our team will meet with you for an in-person assessment and to answer questions. If your first meeting is in your home, then the admission, or election of hospice services, may start at that time. If you are in the hospital, hospice will work with the hospital team to arrange an admission upon discharge from the hospital. In rare instances, you may qualify for hospice admission while still in the hospital.

Step 4: Develop A Care Plan

Once accepted into hospice, our team will create a personalized plan based on your medical needs, as the emotional and spiritual needs of you and your loved ones involved in your care. The hospice team involved in developing your care plan includes hospice doctors, nurses, nursing assistants, social workers, spiritual support coordinators, and volunteers.

Step 5: Begin Care

Hospice is provided wherever you live which includes private home, adult family home, assisted living and nursing homes.

Our goal is to make your transition into hospice care a smooth, simple and supportive experience for you, your loved ones, and everyone involved in your care, so that you can focus on your goals and wishes through the final stages of a serious illness.

Request More Information

If you are ready to begin care, call us at 509-525-5561. You can also contact us by clicking the button below.

Roles Of People - What To Expect

Hospice care involves a dedicated team working together to provide comprehensive support during the end-of-life journey. Here’s what you can expect from the different members of the hospice team:

Patient's Primary Physician

Hospice Nurse

Hospice Aide

Social Worker

Spiritual Counselor

Hospice Volunteer

Bereavement Counselor

Hospice care is a team approach – your physician, the hospice medical director, a registered nurse, a social worker, a chaplain are assigned to the team. The team may also include a nurse’s aide and/or a volunteer. While we teach, support, and encourage the patient’s loved ones and caregivers, it is important to note we are not able to provide bedside nursing care around-the-clock.

Helpful Information when Considering Hospice

What is Hospice?

Hospice is a comprehensive model of care designed to meet the needs of individuals, and their loved ones, who are dealing with a life-limiting illness, and whose goals of care are focused on quality of life rather than a cure. Hospice care is comfort-focused, addressing symptoms such as pain, as well as emotional and spiritual support for individuals and their loved ones. Hospice services are provided wherever an individual lives. This may include a private home, adult family home, assisted living facility, or skilled nursing facility. At times, when symptoms cannot be effectively managed elsewhere, hospice care may be provided in a hospital. This is rare and generally short-term.

Who is Eligible for Hospice?

Hospice care is for individuals with a life expectancy of months versus years. Medical eligibility is defined as a life-limiting prognosis of 6 months or less of life if the disease runs its normal course. Eligibility is determined by your medical provider, if you have one, and a hospice physician. If you do not have a medical provider, a hospice physician can serve as your provider. In addition to cancer, some common hospice diagnoses are dementia, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), stroke (CVA) and Lou Gehrig’s disease (ALS). A hospice team member will complete an eligibility evaluation during the assessment/admission visit.

Where Does Hospice Happen?

Hospice is a model of care, and not a “place” to go at the end of life. Hospice care is most often provided in the hospice patient’s “home,” which could be a private home, adult family home, assisted living facility, skilled nursing facility, a hotel room, etc. While most hospice care can be managed in the home, there may be times when a higher level of care is needed in order to manage acute and severe symptoms that cannot be managed at home. This is typically short-term inpatient care provided at a hospice contracted-hospital and is called Hospice General Inpatient Care (GIP).

Who Pays for Hospice?

Medicare, Medicaid, and many private insurance plans provide a specific hospice benefit. Hospice services are fully covered under both the Medicare and Medicaid hospice benefit. Private insurance coverage is determined by your specific plan. Since services are covered on a daily basis, any copayments or coinsurance will generally apply on a per day basis. The hospice care team is available to help with questions you may have. However, please contact your insurer if you have questions about your specific hospice benefit.

What Does Hospice Cover?

The hospice care team provides comfort focused care with intermittent visits.

Registered nurses provide clinical management, nursing care, and support.
Social workers provide counseling and facilitate access to resources.
Spiritual Support Counselors provide spiritual, mental, and/or emotionalsupport.
Certified nursing assistants provide personal care and companionship.
Hospice physicians collaborate with the patient’s medical provider for management of care.
Pharmacists consult on medication management.
Trained volunteers offer companionship and enrichment for patients and can assist the caregiver with simple errands.
24/7 phone availability for registered nurse consult and support.
After-hours nursing visits for urgent clinical needs.
Bereavement services for 13 months following the loss of a loved one.

Hospice covers medications for comfort and management of symptoms related to the hospice diagnosis. These may include medications for pain or discomfort, shortness of breath, nausea, or anxiety. The nurse will discuss medications at the initial nursing assessment visit, and then continue discussions at subsequent visits. Typically, medications change during the course of hospice care.

Can I Continue Medications or Treatments for my Condition While on Hospice?

Hospice care focuses on comfort and quality of life. Hospice covers all medications that are related to the hospice diagnosis and needed for alleviating symptoms. Hospice does not cover curative medications as the goal of hospice is comfort. Hospice also provides medical equipment and supplies related to the hospice diagnosis. These may include:

Does Hospice Provide Fulltime Caregiving?

Hospice does not provide full-time caregiving. Hospice staff visit intermittently. The frequency of visits is determined by the ongoing assessment of clinical needs and may change throughout the course of care. A nursing visit occurs at least bi-weekly, and typically visits from all members of the hospice team increase as illness progresses. Patients and their caregivers can contact their hospice care team by phone, Monday-Friday, 8:30am – 5:00pm, if they have questions or needs between scheduled visits. On-call nurse support is available 24 hours per day for more urgent needs. The hospice social worker is a resource to offer practical and emotional support while patients and families determine a full-time caregiving plan.

Does Hospice Cover “Room and Board” Expenses?

Hospice does not cover expenses related to housing, food, or personal care. Individuals must cover these costs either through private payment or through Medicaid (if they qualify). Some private insurances, as well as Veteran’s benefits, may provide some coverage for room, board, and daily personal care. If you or your loved one resides at a facility, it is important to work with facility staff to determine how starting hospice may impact you or your loved one’s expenses.

Can I get Home Health While on Hospice?

Medicare and other insurers will not cover hospice and home health simultaneously. The goal of home health is to rehabilitate and recover, while the goal of hospice is comfort. Certain limited therapy services may be included in the hospice plan of care based on the hospice nursing assessment.

Can I go to the Hospital While on Hospice?

Typically, people receiving hospice care wish to avoid returning to the hospital, and hospice support can help achieve that goal. Going to the hospital for lifesaving or lifeprolonging interventions or treatments is generally not aligned with the hospice model of care. However, there are times when hospital-level care may be indicated for acute symptom management. It is important to contact the hospice team to discuss options before going to the hospital or emergency department. All care for your hospice diagnosis must be provided directly by your hospice agency or arranged through your hospice agency. Seeking services independently could result in personal financial responsibility for those services.

What if my Symptoms are too Severe?

If more intensive medical care is needed, the care team may recommend care in a hospice contracted-hospital. This is called Hospice General Inpatient Care (GIP). GIP is typically short-term and continues until symptoms are managed. Once symptoms are controlled, the patient will return to their home setting.

How Long can I Receive Hospice Services?

An individual can receive hospice care as long as they are deemed eligible for hospice as determined by the hospice team, based Medicare eligibility criteria. Sometimes people receive hospice services for over six months. Sometimes a person’s condition stabilizes, or improves, and they are no longer medically eligible for hospice services. If an individual is discharged from hospice, services can be restarted again in the future once medical eligibility for hospice is established. Private insurance plans generally have limitations on the duration of hospice services.

How do I Start Hospice Services?

Anyone may contact Walla Walla Community Hospice to request a hospice evaluation. If you or a loved one is at a care facility or hospital, the social worker or medical team can assist you with the referral to hospice. We will work with you to schedule a hospice assessment or admissionvisit. A hospice team member will complete an evaluation during the initial visit to determine if you or your loved one qualify for services.

It is important that the Durable Power of Attorney(s)/legal decision maker is present during the hospice evaluation/admission visit. If the patient cannot make medical decisions, and the DPOA/legal decision maker is not able to attend, it is critical that the hospice admission forms are signed in advance. The hospice admission cannot take place unless this occurs.

Contact Walla Walla Community Hospice at 509.525.5561 if you have any questions. If you have a confirmed hospice assessment/admission visit, but your plans or circumstances change, and you no longer wish to proceed with hospice, please call us immediately to notify us about your decision. This allows us to reschedule your appointment time with another individual in need of hospice services.

Why Choose Walla Walla Community Hospice?

Walla Walla Community Hospice is your local non-profit hospice provider, serving individuals in the Walla Walla Valley since 1980. Our dedicated and experienced team is committed to partnering with you and your loved ones to ensure you experience compassionate person-centered care when facing a life-limiting illness.

When there isn’t a cure, there’s the miracle of care.

Request information

If you are ready to begin care, call us at (509) 525-5561. You can also submit an online request by clicking the button below.