Frequently Asked Questions
What does it mean to be homebound?
A patient may be considered homebound (confined to the home) if the following two criteria are met:
- The patient must either need the aid of supportive devices; have the need for special transportation, or the assistance of another person in order to leave their place of residence; OR, have a medical condition such that leaving his or her home is not advisable.
- There must exist a normal inability to leave the home AND leaving the home must require a significant effort.
If a patient needs to leave the home, the following requirements apply:
- For periods of relatively short duration
- For the need to receive health care treatment
- For religious services
- To attend adult daycare programs; or
- For other unique or infrequent events (for example, funeral, graduation, trip to the barber, etc.)
What are Skilled Services?
Skilled services are those that can only be provided by licensed professionals such as:
- Registered nurses;
- A medical director (to provide oversight for clinical quality and medical policies/practices);
- Licensed practical nurses;
- Licensed physical and occupational therapists;
- Speech-language pathologists; and
What is Palliative Care?
Palliative Care is a type of medical care that focuses on helping seriously ill patients. It focuses on providing relief from the symptoms, pain and stress. Palliative Care is a medical specialty, just like cardiology, oncology or pediatrics. The goal is to improve quality of life for both the patient and the family.
What is the difference between Palliative Care and Hospice?
Palliative Care focuses on pain and symptom management for all patients at any stage of a serious illness. It can be provided alongside curative treatment, or as part of hospice services.
Hospice care focuses on creating a natural and comfortable end-of-life experience for those dealing with a life expectancy of usually 6 months or less. It is provided when a patient and family decide that a cure for the illness is no longer feasible or reasonable. Hospice helps the patient and family to live peacefully, positively and as fully as possible through the end-of-life journey. Hospice care includes a full range of services, including medical, pharmaceutical, social and spiritual support.
All hospice care is palliative care, but not all palliative care is hospice.
Will I have to give up my own physician if I choose Hospice care?
One of the important aspects of hospice is coordination of care by the hospice team. The hospice team includes many people, with different skills, working together to provide care. Your doctor, you and your family are included in the plan of care as part of the Hospice team.
Will my medication plan change in Hospice care?
Medications related to the terminal illness and for pain and symptom control are covered by the hospice benefit. Medication regimens are set up in the plan of care to meet your comfort needs. When you choose hospice care, you and your doctor have decided you are no longer seeking to cure for your terminal illness. Medications to make you well that are no longer effective, chemotherapy for example, would be discontinued.
What is an Advance Beneficiary Notice?
The Advanced Beneficiary Notice of Non-coverage is issued by providers (home health agencies, and hospices), in situations where Medicare payment is expected to be denied. The VNA will provide you with an ABN form upon discharge when your home health goals are met, your home health skilled needs are resolved, or you are no longer homebound.