Medicare Hospice Benefit

Where is Hospice care provided

Allegiant Hospice will meet patients wherever they are. Most hospice care occurs at home because that is where people usually prefer to live. Hospice care can also come to people who live in extended care facilities, such as assisted living centers or nursing homes. Patients who need advanced 24-hour care and assistance may be eligible for inpatient care at a Hospice Inpatient Unit (IPU).

Selecting a Hospice that’s right for you

There are over 50 Medicare certified Hospice agencies in the Phoenix-metropolitan area. It is important to find out about the quality of care that each hospice offers. We suggest you interview a few agencies to make an informed decision.

  • Are all hospices the same? – All Medicare hospice agencies follow the same regulations – differences typically lie in the quality of care each agency can provide.
  • How do I decide if hospice is the appropriate care choice for me? – You can always discuss your thoughts with a representative of the Hospice and/or your Physician.
  • How do I choose among different hospice programs? – Start by gathering a list of local hospice agencies in your area and request a meeting or telephone call with each to get a feel for the agency. Discuss your goals and expectations to make sure you find a good fit.
  • Are all hospices paid the same? – Medicare reimburses all Hospice providers at a daily rate based on regional location (for-profit and not-for-profit has no distinction). Differences often lie in corporate structure & tax responsibilities

Frequently Asked Questions

How can I be sure that quality hospice care is provided?
Allegiant Hospice uses tools to see how well we are doing in relation to quality hospice standards. In addition to our Internal Quality Assurance Program, we use family satisfaction surveys developed by the National Hospice & Palliative Care Organization to get feedback on the performance of our program.
Do state and federal auditors inspect and evaluate hospices?
Yes. There are state licensure requirements that must be met by hospice programs in order to deliver care. In addition, hospices must comply with federal regulations in order to be approved for reimbursement under Medicare. Allegiant Hospice periodically undergoes inspection to be sure we are meeting regulatory standards in order to maintain their license to operate and the certification that permits Medicare reimbursement. Allegiant Hospice also voluntarily adheres to the Hospice Quality Standards set by the Joint Commission which meet or exceed State & Federal Regulation.
What happens if I cannot stay at home due to my increasing care need and require a different place to stay during my final phase of life?
Allegiant Hospice has made arrangements with multiple Hospice Houses and Skilled Nursing facilities throughout Maricopa and Pinal County to care for patients who cannot stay where they usually live. Short term arrangements can be made if the patient qualifies for a more intensive level of care. However, care in these settings may not always be covered under the Medicare Hospice Benefit. We will work with you to find out if insurance or any other payer covers this type of care or if patients/families will be responsible for payment.
Can I be cared for by hospice if I reside in a nursing facility or other type of long-term care facility?
Hospice services can be provided to a terminally ill person wherever they live. This means a patient living in a nursing facility or long-term care facility can receive specialized visits from hospice nurses, home health aides, chaplains, social workers, and volunteers, in addition to other care and services provided by the nursing facility. Allegiant Hospice and the nursing home will have a written agreement in place in order for the hospice to serve residents of the facility.
Is hospice available after hours?
Allegiant Hospice is on duty 24/7. Care is always available, including after the administrative office has closed. Staff are available to respond to a call for help within minutes, if necessary.
Myth: Patients must be homebound to qualify for hospice care.
Many hospice patients are able to continue an active lifestyle including visiting friends and family, and pursuing meaningful interests and activities. Hospice’s goal is to enhance quality of life and does not require homebound status.
Myth: Hospice is only for people with cancer.
Though many patients do have cancer, hospice serves terminally ill people of all ages with all types of progressive diseases. These include heart, lung, kidney, vascular and neurological diseases, as well as AIDS and Alzheimer’s.
Myth: A physician decides whether a patient should receive hospice care and which agency should provide that care.
The role of the physician is to recommend care, whether hospice or traditional curative care. It is the patient’s right and decision to determine when hospice is appropriate and which program suits his or her needs. Before entering a hospice, however, a physician must certify that a patient has been diagnosed with a terminal illness and has a life expectancy of six months or less.
Myth: Once a patient elects hospice, he or she can no longer receive care from the primary care physician.
Allegiant Hospice will work closely with your primary physician and we consider the continuation of the patient-physician relationship to be of the highest priority.
Myth: Once a patient elects hospice care, he or she cannot return to traditional medical treatment.
The Medicare Hospice Benefit affords patients the right to reinstate traditional care at any time, for any reason. If a patient’s condition improves or the disease goes into remission, he or she can be discharged from a hospice and return to aggressive, curative measures, if so desired. If a discharged patient wants to return to hospice care Medicare will generally allow readmission.
Myth: After six months, patients can no longer receive hospice care through Medicare.
According to the Medicare hospice program, services may be provided to terminally ill Medicare beneficiaries with a life expectancy of six months or less. However, if the patient lives beyond the initial six months, he or she can continue receiving hospice care as long as the attending physician recertifies that the patient is terminally ill. Medicare, Medicaid, and many other private and commercial insurances will continue to cover hospice services as long as the patient meets hospice criteria of having a terminal prognosis and is recertified with a limited life expectancy of six months or less.
Myth: Patients only receive hospice care for a limited amount of time.
The Medicare benefit, and most private insurance, pays for hospice care as long as the patient continues to meets the criteria necessary (unlimited benefit periods). Patients may come on and off hospice care, and re-enroll in hospice care, as needed.
Myth: Hospice is a place.
Hospice care typically takes place in the comfort of an individual’s home, but really can be provided in any environment in which a person calls home, including a nursing home, assisted living facility, or residential care facility. Hospice is better thought of “as a concept of care.”