What are the general criteria for referrals to Community Hospice?

In order to receive services from Community Hospice, including inpatient care at Hospice House, the patient must meet all of the following conditions:

• Terminal prognosis of 6 months or less if the disease follows a normal and expected course.
• Choosing palliative care (i.e. symptom control, declines interventions that alters the course of the terminal diagnosis).
• Community Hospice receives medical documentation to support the terminal diagnosis

Note: The attending physician will need to certify the patient as terminally ill and follow the patient in hospice care. CHI Medical Directors may be willing to become attending if the patient/family/current attending or the patient requests this.

Community Hospice will follow patients in private residences, county jail, contracted Skilled Nursing Facilities (SNFs) and Residential Care Facilities for the Elderly (RCFEs) which possess a current hospice waiver from DSS.

What are the criteria for admission to the Alexander Cohen Hospice House?

The Alexander Cohen Hospice House may be considered as an inpatient option for the patient if the patient meets any of the following:

• Physical symptoms which cannot be handled at home (i.e., IV meds, family in shock and ill-prepared)
• Short-term caregiver relief

Note: The Alexander Cohen Hospice House is not a long term care facility. As such, we provide care for patients for a brief period of time until the patient's care can be provided in a residence by family or professional caregivers (i.e. SNF, RCFE, hired caregivers).

Who may refer a patient to hospice care?

Referrals are accepted from anyone who identifies the need for hospice care. Applications for admission can be obtained by contacting Community Hospice. Home care services are available to patients living in Stanislaus and South San Joaquin counties , as well as outlying areas. Inpatient care is available to all patients, no matter where they live.

Once a patient chooses hospice care, can he or she continue to receive care from their primary physician?

Hospice reinforces the patient-primary care physician relationship by advocating either office or home visits, according to the physician and patient's preference. Community Hospice works closely with the primary care physician and considers the continuation of the patient-physician relationship to be of highest priority.

If my primary physician is unable to follow me in hospice who will?

Hospice will assign one of our physicians, medical director or assist you in locating a physician near you who can also make a home visit.

What does the hospice admission process involve?

One of the first things Community Hospice will do is contact the patient's physician to make sure that he or she agrees that hospice care is appropriate for this patient at any time. (Most hospices have medical staff available to help patients who have no physician.) Then one of our liaisons will meet with the patient and family to explain how hospice care works.

The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital. The so-called "hospice election form" says that the patient understands that the care is palliative (that is, aimed at pain relief and symptom control rather than curative. It also outlines the services available. The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage. Please note that as a non-profit hospice, Community Hospice is committed to caring for anyone who needs us, regardless of ability to pay.

What happens if the patient changes their mind regarding palliative care and decides that they would like blood transfusions, chemotherapy, tube feedings or radiation therapy?

Contrary to the common myth, hospice patients can continue to receive certain therapies under the direction of the hospice Medical Director and attending physician, along with the interdisciplinary hospice team. Each patient's plan of care is evaluated individually. If the goal of the therapy is symptom management, i.e. quality of life, chances are that the therapy will continue to be integrated into the plan of care.