Hospice of the Comforter

We can thank the pioneers of the hospice movement who worked diligently to introduce quality end-of-life care to the United States. Compassion AND passion motivated these innovators to learn from the founders of hospice care in England and bring it to us. 

The work in advocating for hospice care in our country continued in 1972 when Dr. Elisabeth Kubler-Ross testified at the first National Hearings on the subject of Death with Dignity, conducted by the U.S. Senate Special Committee on Aging. She noted, “We isolate both the dying and the old,” and recommended that legislation be developed to ensure money was appropriated to provide medical, emotional and spiritual care needed at the end of life.

Approximately 10 years later, in 1982, Congress included a provision to create a Medicare Hospice Benefit in the Tax Equity and Fiscal Responsibility Act. Senators Robert Dole from Kansas and John Heinz from Pennsylvania led these efforts. In 1986, the Medicare Hospice Benefit was made permanent by Congress.

Years later, in 2002, Senator Dole wrote what turns out to be a very timely quote in 2011. “The Medicare Hospice Benefit is the story of how a bipartisan group in Congress identified a need early on, crafted a solution, tested it with a demonstration project and then wrote final legislation that reflected the needs and wants of millions of Americans.”

The work of all of these people and many others has given us the relatively unknown and sometimes misunderstood Hospice Medicare Benefit.

How the HMB affects our patients, families and those of you reading this blog is at times complex, and is best explained by highlighting what it provides to its beneficiaries. It allows for the quality end-of-life care that Dr. Kubler-Ross advocated for, and eases financial burdens.

When speaking with patients and families who are considering our program, it is easy to understand their concern over the financial costs of hospice care. When I was an Admissions Nurse, I was always affected by the looks of distress on the faces of families. I understood that facing what comes with a terminal diagnosis was traumatic on its own. But I also knew that financial worry was setting in as I described the many services we bring to our patients and families. I was sure that this kind of care sounded expensive to them! It didn’t take long for me to learn to alleviate their fears of expenses early on in the conversation.

We explain to our patients and families that the Hospice Medicare Benefit is offered under certain conditions. Patients electing the HMB must be eligible for Medicare Part A (hospital insurance), and also need to select a Medicare approved hospice program. In addition, the patient’s physician as well as a hospice physician needs to certify that there is a terminal condition, and if this disease condition runs its usual course, the patient has less than 6 months to live. Hospice care is delivered for specific periods of time. Once certified to be eligible for hospice, the patient receives services initially for two 90 day periods. This is followed by 60 day periods. At the beginning of EACH period of care, the hospice doctor must recertify that you are terminally ill. You then continue to get hospice care.

When these conditions are met, the patient or the patient’s health care surrogate signs a statement choosing hospice care instead of other Medicare covered benefits to treat the terminal illness. It is important to note, here, however, that Medicare still pays for covered benefits for health problems unrelated to the terminal illness.

As you can see, the Hospice Medicare Benefit is an excellent program for those who elect to use it. Details of the hospice services provided under the HMB will reveal why it is so important for people to know that this benefit is offered.

At Hospice of the Comforter, we provide care using an Interdisciplinary Team approach. This means that our patients can utilize the services of a Physician, RN Case Manager, Social Worker, Home Health Aide, Chaplain and Volunteer. Family members and patient caregivers are also considered to be an essential part of our team approach. And although our hospice team members are experts in end-of-life care, we make sure that our patients and families understand that they captain the team as decisions are made about THEIR end of life. It is our job to ensure that the patient and family goals are met safely and well.

Recognizing that continued care is needed for our hospice families, we offer bereavement counselors who keep in touch with the family for up to 13 months after the death of a loved one. We also provide individual and group grief support.

Our own Home Medical Equipment facility at Hospice of the Comforter means that we can deliver and maintain the supplies needed by our patients. Medications that are related to the hospice diagnosis are included as part of the HMB. Hospice of the Comforter’s Physicians and Clinical Consultant Pharmacist collaborate with a pharmacy specializing in end of life care, and medications are delivered directly to the patient. This gives the family one less thing to do during this busy and stressful time of life.

If you choose hospice for your care, your own physician can continue to be your doctor, or might consult with our physicians. Again, we support your wish to have your goals met.

There are some things that are not covered under the Hospice Medicare Benefit. These exclusions are curative treatment, and medications that are not for symptom control or pain relief from the terminal illness. Also, the HMB will not cover care in an emergency room, inpatient facility or ambulance transportation unless it is arranged by the hospice or is for an unrelated illness. For patients in Assisted Living Facilities or Skilled Nursing Facilities, the room and board continues to be paid for outside of the HMB.

At times, our hospice patients may be eligible for different levels of care, and this, too, is covered under the Hospice Medicare Benefit.

Hospice services can also be covered by Medicaid and most private insurance. At Hospice of the Comforter, no patient will ever be denied services because of inability to pay. In 2010 we provided $547,737 to members of our community. Hospice of the Comforter is the only nonprofit hospice serving Orange, Osceola and Seminole counties.

Click here for more information about the Hospice Medicare Benefit. 

Thanks to the work of early hospice advocates and bipartisan legislators, the Hospice Medicare Benefit has grown to become a vital entity in delivering high quality end of life care in our country. Please consider this benefit, and join us as we endeavor to educate our community about the HMB and the goal to help patients live with dignity and comfort until the time of death.

“Never doubt that a small group of thoughtful committed citizens can change the world; indeed, it's the only thing that ever does.”

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