Frequently Asked Questions

The Medicare hospice benefit provides for four levels of hospice care: Routine Home Care, General Inpatient Care, Continuous Care, and Respite care. Patients may be admitted at any level of care. These levels of care are designed specifically to meet the changing needs of hospice patients as symptoms and circumstances necessitate.​Routine Care:  Provides patients with regularly scheduled visits from their hospice team. Support includes visits from nurses, medical social workers, home health aides, a hospice chaplain/counselor, and sometimes volunteers. Patients also have access to home medical equipment, medications, personal supplies, therapy and 24/7 on-call nursing support.  Routine Care is the most common level of hospice care.​​Continuous Care:  Provides more intense nursing and support services when the patient is going through a medical crisis or experiencing severe symptoms, such as unrelieved pain.  Continuous care is defined as a minimum of 8 hours of care in a 24 hour period.  At least half of those 8 care hours must be provided by a Registered Nurse.  ​General Inpatient Care:  A short term level of care designed to manage symptoms that cannot be managed in the patient's home. Typically used for only a few days, General Inpatient Care is provided in a nursing home, hospital or hospice inpatient unit.  Once the situation improves and the symptoms are managed, the patient typically returns to his or her home with routine home hospice support.​​Respite Care:  A short term level of care (up to 5 days) intended to give caregivers, (often the spouse, children or other family members), the opportunity to take some time away from their responsibilities. This respite period allows everyone to emotionally recharge, physically refresh and better prepare to manage the day-to-day challenges of caregiving in the face of a chronic life-threatening illness.

In addition to nursing, aide, social work, counseling, and other services, hospice also provides medications and equipment related to the patient's terminal illness.  Medications that are unrelated to the terminal illness are not covered by hospice.  These medications continue to be covered in whatever manner they were covered prior to the patient coming on hospice (Medicare, Medicaid, or private insurance, for example).

This can be a difficult question to answer, because it is a deeply personal one and we naturally to want to continue to pursue every available option for treatment for ourselves or our loved ones.  It's helpful to discuss treatment options/benefits with your Primary Care Physician or Specialists to see if hospice is right for you. Some common indications hospice may be appropriate include:                  Increased frequency of hospitalizations/ER visits Frequent or recurrent infections Increased falls Uncontrolled pain, shortness of breath, nausea or vomiting  Increased dependence for assistance with activities of daily living Changes in mental capacity/increased sleeping Reduced desire to eat resulting in weight loss

Hospice is a supplemental care provider, which is not the same as a primary caregiver. Hospice patients should have a primary caregiver, such as a family member or be in the care of a facility that offers ongoing caregiver services. However, hospice care is available in an ‘on-call’ capacity 24 hours a day, seven days a week, with the ability to make visits for patients who have had an emergency or change in condition any time of the day or night.

Commonwealth Hospice is available to respond to patient emergencies 24 hours a day, 7 days a week. We offer dedicated on-call nursing for changes in condition that occur outside of normal business hours.  Commonwealth also partners with numerous skilled nursing and personal care facilities in the Pittsburgh area that can assist in providing emergency care, if caregivers are unable to meet a patient's changing needs.

Yes.  Hospice services can be provided to a person who has a life-limiting illness wherever that person lives. This means a person 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 the care and services provided by the nursing facility. The hospice and the nursing home will have a written agreement in place in order for the hospice to serve residents of the facility. The Medicare Hospice Benefit will cover the care related to your terminal illness, but it will not cover any charges related to the facility (room and board, laundry and housekeeping fees, etc.).

Hospice is covered by Medicare Part A, Pennsylvania Medicaid, the VA, and most private insurance plans. For most patients and families, there is little or no out-of-pocket cost. The benefit covers our care team’s visits, plus the medications, medical equipment (such as a hospital bed, wheelchair, or oxygen), and supplies related to the hospice diagnosis. Our team will check your coverage and explain any costs before care begins, so there are no surprises.

Hospice does not cover treatments aimed at curing the terminal illness, or room and board in a nursing home or personal care home. For residents who qualify for Medicaid, room and board may be covered through Medicaid. Our social workers can help families understand their options and connect them with local resources.

When you call, one of our team members will listen to your loved one’s situation, answer your questions, and explain how hospice works. There is no obligation. If you’d like to move forward, we coordinate with your loved one’s doctor and schedule an admission visit, typically within 24 hours, at home or wherever they live.

A Commonwealth nurse will meet with the patient and family, review their health and medications, and talk about goals and wishes for care. Together, we create a personalized care plan. We arrange for any needed medications and equipment to be delivered, and we introduce you to your care team. From that day on, you can reach a nurse 24 hours a day, 7 days a week.

Your care team will visit regularly. The team includes a nurse case manager, a hospice aide, a social worker, and a chaplain or counselor, with volunteers and therapies available as needed. Visits are scheduled around the patient’s needs, and the care plan is updated as those needs change. Families are included every step of the way.

Yes. A patient can choose to leave hospice at any time, for any reason. They can return to curative treatment and re-enroll in hospice later if they wish. Some patients also improve while on hospice and are discharged because they no longer meet eligibility.