Frequently Asked Questions

General

Home Health with Palliative Care Pathway:

  • There is no charge to Kaiser Permanente Senior Advantage, Medicare Cost, MediCal, and Medicare Fee-for-Service members. Some Commercial members covered by group plans are subject to visit limits and/or deductibles for receiving home health or home health palliative care services when ordered and provided by Kaiser Permanente.
  • Other limitations may apply and are described in your election of benefits.
  • The following services are not covered under the Home Health benefit: Custodial Care, Respite Care, Homemaker and Housekeeping services, Long Term Rehabilitation Service in the Home, Transportation, and Nutritional Supplements.

Hospice:

  • There is no charge to Kaiser Permanente Senior Advantage, Medicare Cost, MediCal, Medicare Fee-for-Service members and some Commercial members covered by group plans for receiving the hospice services when ordered and provided by Kaiser Permanente. Medicare and Kaiser Permanente Senior Advantage members have the option to choose any non-Kaiser Permanente Medicare Certified Hospice Agency to provide Hospice Services. The patient may be required to pay benefit rate for non-hospice related care items (medications unrelated to the terminal illness).

At the start of care, the nurse will review your history and complete an assessment. The nurse will collaborate with a physician to see if you are eligible to be admitted into the program. The nurse will explain the services provided based on your plan of care and you will have to sign a consent. You may want to have your caregiver or family member/advocate present during this visit.

A plan of care directs the type of services and treatments you will receive. Your doctor will decide:

  • The type of services needed
  • The type of health care professional providing your services
  • How often you will need the services
  • The type of home medical equipment you will need
  • The type of food you may need
  • The results your doctor expects from the therapy
  • The home health agency staff provides care according to your authorized plan of care. We encourage the patient and caregivers to participate in the treatment plan as it relates to goal planning.

At the start of care the RN case manager will assesses your clinical situation and develop an individualized care plan including the frequency of visits.

  • Home Health and Home Health Palliative Care:
    • The KP partner agency will provide Home Care services and will collaborate with your referring physician.
  • Hospice:
    • The KP partner agency will provide Hospice services. Usually, their hospice medical director will take over as the attending physician.

You may request Hospice services, however Home Health services, including Home Health Palliative Care, are not provided within a skilled nursing facility due to regulatory guidelines.

California state law requires that all needles and syringes, which are shortened to medical ‘Sharps’, must be disposed of properly and NOT thrown out in regular household trash.

To find the nearest Sharps Waste Disposal collection site in your area:

  • DO NOT put sharp objects in any container that will be recycled or returned to a store
  • DO NOT use glass or clear plastic containers to dispose of Sharps
  • DO NOT keep containers with sharp objects within reach of young children

Home Health

Home Health care allows patients to receive needed health care services, while surrounded by family and friends at home reducing the time it takes to recover from illnesses, injuries or surgery, and shorten hospital stays. A nurse or a therapist will teach patients how to manage their illness through education and training, so they may achieve the highest level of independence possible while remaining in their home.

In order to receive Home Health services, the patient must be homebound. A patient is considered homebound when it takes an extreme effort to leave the home. For example, you need assistance or support to leave home safely. Patient may require oxygen, walker, wheelchair, or another person to assist with ambulating safely and driving.

All services provided by Home Health are ordered by your physician. Services may include:

  • Skilled nursing
  • Infusion nursing
  • Ostomy
  • Wound care
  • Physical/occupational/speech therapy
  • Medical social workers
  • Home health aides

All of following must be met to qualify for Home Health: a physician’s order, you must be homebound, and the care provided must be a skilled need. If you are using your Medicare- Part B benefit, you will be utilizing only rehabilitative services and you do NOT have to be homebound.

For Medicare beneficiaries, Medicare certifies each patient for an episode of care lasting 60 days. You can be recertified for an unlimited number of episodes if you meet the criteria.

For non-Medicare members, please refer to your election of benefits for specific coverage information or contact Member Services.

To cancel your appointment please call your designated Home Health office and ask to speak to the scheduler.

Home Health with Palliative Care Pathway

An integrated team approach to the care of patients facing life limiting conditions that do not qualify for Hospice care. The team may include a RN case manager, physician, social worker and other home health disciplines as needed based on the plan of care. The goal of the program is to improve quality of life while optimizing symptom control of your chronic illness.

Home Health with Palliative Care Pathway is a program under the Home Health benefit. You could be referred to this program by your physician if you meet certain qualifications. Patient must be homebound, have a skilled need, and a life limiting illness with a prognosis of 12 months or less. Home Health with Palliative Care Pathway is geared towards patients who desire symptom management and receive care in their home.

Hospice is care provided to a person who has been diagnosed with a terminal illness. Hospice care provides you with physical, emotional, and spiritual comfort, and helps relieve symptoms such as pain and suffering from nausea. Hospice also provides support services to your family and caregivers.

There is a physician involved with your Home Health with Palliative Care Pathway team, so there is no need to follow up with your Primary Care Physician. However, you may follow up with your specialty physician as needed.

No, but as your disease progresses you may continue discussions with your Home Health with Palliative Care Pathway team to modify your plan of care.

In order to receive Home Health with Palliative Care Pathway services, the patient must be homebound. Patient is considered homebound when it takes an extreme effort to leave the home. For example, you need assistance or support to leave home safely. Patient may require oxygen, walker, wheelchair, or another person to assist with ambulating safely and driving.

We understand that patients and caregivers may face very difficult situations. A 24-hour phone number will be provided to you. This number will put you in touch with a palliative care-trained nurse who will assist you over the phone, arrange for a home visit when necessary, or recommend hospital care if necessary.

In certain instances, 911 services may be a useful tool when used in coordination with the Home Health Palliative Care team. Ask the Home Health with Palliative Care Pathway team for more information about this.

No, after your care team helps you define and meet your palliative care goals- whether improving and maintaining your symptoms or function – you will be reevaluated periodically for appropriateness of continued services. Your nurse will consult with your Home Health with Palliative Care Pathway physician about whether to continue your Home Health with Palliative Care Pathway, return your care back to the clinic, or transfer you to another program in the continuum of care such as Hospice.

No, Home Health with Palliative Care Pathway does not provide a caregiver. Our social workers will help you explore resources in the community to hire a private caregiver. A caregiver is not a covered benefit; however, you may qualify under MediCal/VA or other benefits. You may contact your social worker for further assistance.

Hospice

As a Kaiser Permanente member, you’ll receive high-quality care while in Hospice, just as you do in our medical facilities. Patients with complex conditions choose Kaiser Permanente for their hospice needs because of the continuity of service, high-quality medical care, and caregiver support. Our comprehensive electronic health record contains your medical information, which can be accessed by your Kaiser Permanente providers.

Hospice is care provided to a person who has been diagnosed with a terminal illness. Hospice care provides you with physical, emotional, and spiritual comfort, and helps relieve symptoms such as pain and suffering from nausea. Hospice also provides support services to your family and caregivers.

Home Health Palliative pathways are provided under the Home Health benefit. You could be referred to this program by your physician if you meet certain qualifications. Patient must be homebound, have a skilled need, and a life limiting illness with a prognosis of 12 months or less. Home Health with Palliative Care Pathway is geared towards patients who desire symptom management and receive care in their home.

Hospice is provided anywhere you call home. This includes a house, an apartment, a skilled nursing facility, board and care residence, assisted living facility, or even a friend’s or relative’s home. In some circumstances, if a hospitalization is needed for comfort, hospice can also support you during this time.

The first step is for your physician to refer you to the Hospice department.

A Hospice nurse will call to talk to you about the Hospice program and determine if you qualify. If you do, another Hospice nurse will visit you at your home to ask additional questions, explain more about the Hospice program, review your current medications, and have you fill-out and sign the Hospice consent form. You may receive a follow-up phone call to see how you are doing and give you a chance to ask questions.

You’ll receive a packet of detailed written information about Kaiser Permanente Hospice.

The Hospice nurse in charge of your care, sometimes called your case manager, will visit your home to meet you and discuss your medical needs as well as your non-medical needs, such as support from a social worker, spiritual counselor, or volunteers.

Depending on your needs and what works best for you and your family, other members of the care team will visit your home as well. Although your Hospice physician won’t routinely visit your home, they work closely with the Hospice nurse and other care team members to coordinate your care.

If you need to speak with Kaiser Permanente Hospice care team staff, call the Hospice department 24 hours a day, 7 days a week.

The goal of Hospice care is to provide a comfortable life, away from the inconvenience or discomfort of excessive or unhelpful medical treatments. The Hospice care team, often working together with your other doctors, can manage your care without the need for regular doctor visits. However, there are some circumstances where a visit to your doctor may be helpful and appropriate.

No, you don’t have to stay in your home. If you’re physically able and interested in going out, you may leave your home. Going outside for a few minutes or for a day trip is up to you. It’s based on what you want to do, as well as what you are physically able to do.

When you begin Hospice, your Hospice physician will create a new medication plan for your medical needs. The focus will be on comfort and treatment of symptoms, like pain, shortness of breath, or anxiety, so some of your medications may no longer be recommended or needed. The Hospice care team can tell you what to do with those medications, which may include stopping them, as well as provide instructions on your new medications.

We understand that patients and caregivers may face very difficult situations. A 24-hour phone number will be provided to you. This number will put you in touch with a Hospice-trained nurse who will assist you over the phone, arrange for a home visit when necessary, or recommend hospital care if necessary.

In certain instances, 911 services may be a useful tool when used in coordination with the Hospice care team. Ask the Hospice care team for more information about this.

Yes, you may choose to discontinue Hospice for any reason at any time. If your life expectancy improves or you decide to seek life-prolonging or curative treatments, your hospice care would be discontinued.

Yes, if you decide later that you are interested in receiving Hospice services again, you can reapply.

If you move within 15 miles or 30 minutes of a Kaiser Permanente service area, you will still be cared for by Kaiser Permanente hospice, although you will probably have a new Hospice care team.

If you move more than 15 miles or 30 minutes outside of a Kaiser Permanente service area, you will be referred to a non-Kaiser Permanente Hospice service. You will still have a phsycian, nurse, social worker, spiritual counselor, and other providers who will be familiar with your health and circumstances.

No, Hospice care does not provide a caregiver. Our social workers will help you explore resources in the community to hire a private caregiver. A caregiver is not a covered benefit; however, you may qualify under MediCal/VA or other benefits. You may contact your social worker for further assistance.