Home Healthcare Agencies
VITAS works with home healthcare agencies to increase patient care and satisfaction
What is hospice? How is it different from home healthcare? Where and when does home healthcare stop and hospice begin? Can they work together?
There are many misconceptions about the role, timing, referral process and payment for hospice for patients receiving home healthcare. VITAS partners with private and Medicare home health agencies for the good of the agency and, more important, the client.
When is a client hospice appropriate?
Home healthcare clients must require skilled care and show improvement from this care. When these goals are no longer realistic, that client can be transferred to hospice care.
What are the benefits to the patient?
When cure is no longer an option, hospice offers a richer, more comfortable end-of-life experience and an easier transition for the patient and family. Palliative care supports the patient’s physical, emotional and spiritual needs. The patient remains at home and, if necessary, receives pain management. He or she maintains quality of life and control over day-to-day decisions for as long as possible.
The hospice team includes a chaplain to provide spiritual support, a social worker to provide emotional support and help with financial issues and planning, volunteers to provide companionship, aides to help with personal care and hygiene, and bereavement specialists to provide family members with grief and loss counseling and help with memorial events. Every patient is unique; so is every VITAS plan of care.
What are the benefits to the home health agency?
VITAS works with agencies to identify clients who may be hospice appropriate. For example, a patient with significant healthcare needs, a history of hospital readmissions and who triggers a LUPA status (Low Utilization Payment Adjustment) may meet criteria for hospice consultation/admission.
Transferring appropriate clients to VITAS helps agencies avoid any negative impact on their Outcome Based Quality Initiative scores. In fact, partnering with VITAS can boost an agency’s Home Health Compare ratings while allowing it to comply with requirements from accreditation entities such as AHCA, CHAP and JCAHO.
An early decision to refer declining patients who are not responding to medical treatment modalities to a hospice evaluation may produce some of the following benefits:
- Lessen agency’s RAC vulnerability by lowering the risk for LUPA billing and hospital readmissions
- Create a more balanced case mix
- Positively impact agency’s Home Health Compare rating
- Allow agency to preserve revenue for a dual diagnosis case when hospice and the agency can provide services to the patient together as long as certain criteria are met
Who orders hospice?
Anyone can request a hospice evaluation. Referrals can be made around the clock by calling 866.41.VITAS or visiting VITAS.com/referral. You need to supply only basic patient information; a VITAS admissions clinician interviews the patient and/or family, contacts the physician and admits the patient if appropriate.
How do VITAS services differ from home healthcare services?
Eligibility for hospice
- Patient must have a terminal diagnosis with a prognosis of six months or less if the disease runs its normal course, as certified by a physician.
- Patient and family must agree to a palliative, rather than curative, plan of care.
- Patient is not required to be homebound.
- A patient’s terminal diagnosis must be recertified periodically. Services and plan of care are determined by initial and ongoing physician/team assessment, combined with the patient’s and family’s wishes.
- If the patient’s attending physician chooses not to assume full responsibility for medical care, a VITAS physician can assume this role, including visits to the patient’s home when necessary.
Routine home care
- An interdisciplinary team consisting of a nurse, social worker, physician, chaplain and hospice aide provides services as needed for optimal palliative care.
- VITAS provides care in shifts in the home for up to 24 hours a day for patients needing acute symptom management.
Assisted living communities and nursing homes
- VITAS can continue services when hospice patients are admitted to assisted living communities and nursing homes, and can initiate services to existing residents of these facilities when they are hospice eligible.
Inpatient hospice care
- Care can be provided in an inpatient setting for short stays for symptom management or to provide family relief, resulting in continuity of care.
- The patient’s attending physician may continue to supervise the medical care in an inpatient setting.
- Prescription and over-the-counter drugs related to the terminal diagnosis are provided at no charge to the patient.
- All equipment and supplies related to the terminal diagnosis are provided at no charge to the patient.
- Provision of equipment, oxygen and other products is determined by the patient’s palliative plan of care, not by traditional Medicare Part B guidelines.
- VITAS Telecare service accesses clinicians who can quickly review electronic information about the patient seven days a week, 24 hours a day.
- Bereavement counseling is an integral part of service to families for at least one year following the patient’s death, at no additional cost.
- Trained lay staff are available for patient and family support.
- VITAS accepts Medicare, Medicaid and most private insurance.