Palliative chemotherapy: harms and benefits weighed in new study – Medical News

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Palliative chemotherapy: harms and benefits weighed in new study

Palliative chemotherapy is treatment designed for terminal cancer patients to prolong survival and ease symptoms but not cure disease. Now, researchers have found that the therapy comes with certain harms, which they say need to be addressed.

The researchers, from the Weill Cornell Medical College, Dana-Farber Cancer Institute and Harvard Medical School, have published their results in the BMJ.

They say their findings uncover a discrepancy between what type of care cancer patients want and what they actually receive.

Overall, the team found that terminal cancer patients who receive chemotherapy during the last months of their lives are less likely to die where they wish and are more likely to undergo invasive medical procedures – including CPR and mechanical ventilation – than patients who did not receive the therapy.

Dr. Holly Prigerson, of Weill Cornell Medical College, says that the reasons for the link are complicated, but they may originate in misunderstanding of the purpose and consequences of palliative chemotherapy.

For the study, investigators assessed data from 386 patients in a federally funded study, called Coping with Cancer.

This 6-year study followed terminally ill people and their caregivers until the patients died, and the researchers looked at how psychosocial factors influenced patient care.

After asking the caregivers to rate their patient’s care, quality of life and where the patient would have wanted to die, the researchers reviewed patient medical charts to determine the type of care they actually received during their last week.

Chemotherapy patients less likely to die where they want

The researchers found that patients receiving palliative chemotherapy were less likely to talk to their oncologists about the type of care they wanted to receive, to complete Do-Not-Resuscitate orders or to even acknowledge they were terminally ill.

The findings reveal that 68% of patients receiving palliative chemotherapy died where they wanted, compared with 80% of those not receiving the therapy.

In detail, 47% of patients who received the therapy died at home, compared with 66% of patients who did not receive the palliative care. Additionally, 11% of patients receiving the chemotherapy died in an intensive care unit, versus only 2% of patients not receiving the therapy.

Dr. Prigerson says:

“It’s hard to see in these data much of a silver lining to palliative chemotherapy for patients in the terminal stage of their cancer. Until now, there hasn’t been evidence of harmful effects of palliative chemotherapy in the last few months of life.”

“This study is a first step in proving evidence that specifically demonstrates what negative outcomes may result,” she adds.

The team also found that patients receiving palliative chemotherapy were more likely to be referred to hospice care much later than those not receiving the therapy.

Hospice care is a place that provides comfort and emotional support for terminal patients, and 54% of the patients receiving chemotherapy were referred to hospice late, compared with 37% of the patients not receiving the drugs.

‘Potential need for oncology practice changes’

The team notes that 56% of the patients from the study were receiving palliative chemotherapy in their final months, and they say this majority of use emphasizes the potential need for changes in oncology practice at academic medical centers.

Dr. Alexi Wright, assistant professor and medical oncologist at Dana-Farber, says:

“We often wait until patients stop chemotherapy before asking them about where and how they want to die, but this study shows we need to ask patients about their preferences while they are receiving chemotherapy to ensure they receive the kind of care they want near death.”

But Dr. Wright adds that their findings should not be interpreted that patients should be denied or not offered palliative chemotherapy:

“The vast majority of patients in this study wanted palliative chemotherapy if it might increase their survival by as little as a week. This study is a step towards understanding some of the human costs and benefits of palliative chemotherapy.”

“Additional studies are needed to confirm these troubling findings,” concludes Dr. Prigerson.

Home Healthcare – Health Benefits #cheap #hotel #reservations

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Health Benefits

Home Healthcare

Home Health Care includes VA’s Skilled Home Health Care Services (SHHC) and Homemaker and Home Health Aide Services (H/HHA).

Skilled Home Health Care (SHHC) Services

SHHC is short-term health care services that can be provided to Veterans if they are homebound or live far away from VA. The care is delivered by a community-based home health agency that has a contract with VA. SHHC is for Veterans who need skilled services, case management, and assistance with activities of daily living (e.g. bathing and getting dressed) or instrumental activities of daily living (e.g. fixing meals and taking medicines); are isolated or their caregiver is experiencing burden.

Homemaker/Home Health Aide (H/HHA) Services

The services of a Homemaker or Home Health Aide can help Veterans remain living in their own home and can serve Veterans of any age. A Homemaker or Home Health Aide can be used as a part of an alternative to nursing home care, and as a way to get Respite Care at home for Veterans and their family caregiver.

VA’s Family Caregivers Program provides support and assistance to caregivers of post 9/11 Veterans and Service Members being medically discharged. Eligible primary Family Caregivers can receive a stipend, training, mental health services, travel and lodging reimbursement, and access to health insurance if they are not already under a health care plan. For more information, contact your local VA medical facility and speak with a Caregiver Support Coordinator, visit www.caregiver.va.gov or dial toll-free 1-877-222-VETS (8387).

Home Telehealth

Home Telehealth, also known as Care Coordination/Home Telehealth, is a service that allows the Veteran’s physician or nurse to monitor the Veteran’s medical condition remotely using home monitoring equipment.

Veterans can be referred to a care coordinator for Home Telehealth services by any member of their care team.

When approved for Home Telehealth, specialized equipment in the Veteran’s home will provide the care coordinator with the Veteran’s health information. The care coordinator will check in with the Veteran by phone, if needed. If any of the Veteran’s health measurements do not seem normal, the care coordinator talks with their physician or nurse and then gets back to the Veteran with next steps.

Hospice Benefits #hospice #buffalo

#medicare hospice benefit

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Hospice Benefits

The Hospice benefit is an optional state plan service that includes an array of services furnished to terminally ill individuals. These services include: nursing, medical social services, physician services, counseling services to the terminally ill individual and the family members or others caring for the individual at home, short-term inpatient care, medical appliances and supplies, home health aide and homemaker services, physical therapy, occupational therapy and speech-language pathology services.

Individuals must elect the hospice benefit by filing an election statement with a particular hospice. They must acknowledge that they understand that other Medicaid services for the cure or treatment of the terminal condition are waived. Individuals may, however, revoke the election of hospice at any time and resume receipt of the Medicaid-covered benefits waived when hospice was elected.

A hospice provider must obtain a physician certification that an individual is terminally ill and hospice services must be reasonable and necessary for the palliation or management of the terminal illness and related conditions. A hospice plan of care must be established before services are provided.

Payment for hospice services is made to a designated hospice provider using the CMS annually published Medicaid hospice rates that are effective from October 1 of each year through Sept 30 of the following year. With the exception of payment for physician services Medicaid reimbursement for hospice care will be made at predetermined rates for each day the individual receives care under one of the following categories or levels of hospice care:

  1. Routine Home Care, (RHC), Hospice Providers are paid one of two levels of (RHC), effective for dates of service on or after January 1, 2016. This two-rate payment methodology will result in a higher RHC rate based on payment for days one (1) through sixty (60) of hospice care and a lower RHC rate for days sixty one (61) or later. A minimum of sixty (60) day’s gap in hospice services is required to reset the counter that determines which payment category a participant is qualified for.;
  2. Continuous Home Care, (CHC), which is furnished during a period of crisis and primarily consists of nursing care;
  3. Inpatient Respite Care, (IRC), which is short-term care and intended to relieve family members or others caring for the individual; and
  4. General Inpatient Care, (GIC), which is short term and intended for pain control or acute or chronic symptom management which cannot be provided in other settings.
  5. Effective January 1, 2016, Service Intensity Add-On which provides that hospice services are eligible for an end-of life service intensity add on payment when the following criteria are met:
    1. The day on which the services are provided is an RHC level of care;
    2. The day on which the service is provided occurs during the last seven days of life, and the client is discharged deceased;
    3. The service is provided by a registered nurse or social worker that day for at least fifteen minutes and up to four hours total and
    4. The service is not provided by the social worker via telephone.

The national hospice reimbursement rates for these four levels of care change annually. Medicaid Hospice Rates for federal Fiscal Year (FY) 2017 are based on the annual Medicare changes and are typically a little higher due to offsets attributable to Medicare coinsurance amounts.

Beginning March 23, 2010, with the enactment of the Affordable Care Act, Medicaid and CHIP-eligible individuals under age 21 who elect the hospice benefit no longer have to waive services for the cure or treatment of the terminal condition and can receive both curative care and hospice care for the terminal condition.

4 Ways to Apply For Social Security and Retirement Benefits #companies #with

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How to Apply For Social Security and Retirement Benefits

The Social Security Administration pays out Retirement Insurance Benefits (RIB) to retirees, as well as administering Medicare, spousal Social Security benefits and survivors’ benefits. You can apply for benefits at your local SSA office. through the mail, by calling Immediate Claims Taking (800-772-1213) or online. Learn more about the process with this step-by-step guide.

Steps Edit

Method One of Four:
Applying for Retirement Benefits Edit

Meet the requirements. In order to retire under Social Security, you must be at least 62 years old and have sufficient quarters of coverage (QOC). Also called Social Security credit, your QOC will help determine how much benefit you’re entitled to. You must have obtained at least 1 QOC for each calendar year between 21 and the year before turning 62. You will not be required to have more than 40 QOC to qualify.

  • Be aware of how your age is calculated. SSA does not pro-rate monthly benefits. Age is calculated by English common law, in which a person obtains their age on the day before their birthday. In order to receive benefit for the month of your birth, you must be born on the 1st or 2nd of the month, making you eligible on the last day of the prior month or the 1st, respectively. If you’re born on any other day of the month, you won’t receive benefits until the following month.

Know when to apply. Retirement Insurance Benefits (RIB) become available when you turn 62, even though that is not currently the Full Retirement Age in America. (To figure out your Full Retirement Age based on your date of birth, click here .) SSA will alter your payments based on when you choose to retire. You have a few options:

  • Retire early. File for RIB 3 months before your 62nd birthday if you want your benefits to start as soon as your birthday passes. Filing early will decrease how much money you receive each month. Use a benefit calculator to figure out the difference in your case.
  • Accrue delayed retirement credits. For each month between age 62 and age 70 that you wait to apply for RIB, Social Security will increase your benefits by a certain percentage. Consult this chart for the exact numbers.

Be aware of how your benefit is calculated. How much money SSA will give you each month depends on a variety of factors, including how much money you contributed to the Social Security Trust Fund, the age at which you file for RIB, your current earned income and any military service. The starting point for figuring out how much benefit you’re entitled to is called the Primary Insurance Amount (PIA). This can be calculated by a few different formulas ; whichever one comes out with the highest amount will be used.

  • Watch out for the Windfall Elimination Provision. If you’ve worked in a job that contributed money to a pension fund instead of the Social Security Trust Fund, your benefits may be offset by the Windfall Elimination Provision (WEP). If you have 30 Years of Coverage (YOC), during which you contributed significantly to the Social Security Trust Fund, the WEP will be waived. If you have 21 to 29 YOC, the impact of the WEP on your benefits will be significantly reduced. There are some other cases in which the WEP will not affect your benefits; learn more here. or use the online WEP calculator .

Submit an application. You can apply for retirement benefits online or through your local SSA office ; or over the phone at (800) 772-1213 (if you are hearing-impaired, call 800-325-0778), Monday through Friday, between 7 a.m. and 7 p.m. Eastern time.

Applying for any type of Social Security benefit requires a lot of verification and paperwork. Make sure you gather the items listed under Things You’ll Need before you begin the application process.

Benefits are disbursed on the 3rd day of each month, as well as the 2nd, 3rd and 4th Wednesdays of the month. The day on which you’ll receive your check depends on a number of factors, such as the date of your birth, and whether you’re receiving other benefits.

You can receive payments outside the United States in most cases. Check this page for more information, or use this tool .

Warnings Edit

You may have to pay taxes on your Social Security benefits. Start here for more information.

If you are paying court-ordered child support, alimony or a tax levy, your benefits may be garnished to meet these obligations.

Things You’ll Need Edit

Your Social Security number

  • Your birth certificate
  • Your W-2 forms or self-employment tax return for last year
  • Your discharge papers for any active military service
  • Your spouse’s birth certificate and Social Security number if he or she is applying for benefits
  • Children’s birth certificates and Social Security numbers, if applying for children’s benefits
  • Proof of U.S. citizenship or lawful alien status if you (or a spouse or child applying for benefits) were not born in the U.S.
  • Your marriage license (if you’re applying for spousal benefits)
  • If you are not a citizen of the U.S. and possess papers issued by INS or the Department of Homeland Security, you may be required to show these to SSA. Never send these documents or a foreign birth certificate to SSA via mail. Always physically take them to your local office, as these documents can be costly or impossible to replace.
  • Your bank routing number and your account number, so your benefits can be directly deposited into your account.





  • Transfer Post-9 #new #gi #bill, #post-9/11, #gi #bill, #wave, #gi, #gibill, #va

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    Attention A T users. To access the menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, etc). 3. To enter and activate the submenu links, hit the down arrow. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links.

    Education and Training

    Transfer Post-9/11 GI Bill to Spouse and Dependents

    The transferability option under the Post-9/11 GI Bill allows Servicemembers to transfer all or some unused benefits to their spouse or dependent children. The request to transfer unused GI Bill benefits to eligible dependents must be completed while servicing as an active member of the Armed Forces. The Department of Defense (DoD) determines whether or not you can transfer benefits to your family. Once the DoD approves benefits for transfer, the new beneficiaries apply for them at VA. To find out more, visit the DoDs website or apply now .

    Type of Assistance

    Eligible Servicemembers may transfer all 36 months or the portion of unused Post-9/11 GI Bill benefits (unless DoD or the Department of Homeland Security has limited the number of transferable months). If you’re eligible, you may transfer benefits to the following individuals:

    • Your spouse
    • One or more of your children
    • Any combination of spouse and child

    Available Benefits and Eligibility

    Family members must be enrolled in the Defense Eligibility Enrollment Reporting System (DEERS) and be eligible for benefits at the time of transfer to receive transferred benefits.

    The option to transfer is open to any member of the armed forces active duty or Selected Reserve, officer or enlisted who is eligible for the Post-9/11 GI Bill, and meets the following criteria:

    • Has at least six years of service in the armed forces (active duty and/or Selected Reserve) on the date of approval and agrees to serve four additional years in the armed forces from the date of election.
    • Has at least 10 years of service in the armed forces (active duty and/or Selected Reserve) on the date of approval, is precluded by either standard policy (by Service Branch or DoD) or statute from committing to four additional years, and agrees to serve for the maximum amount of time allowed by such policy or statute.
    • Transfer requests are submitted and approved while the member is in the armed forces.

    Transfer Process. While in the armed forces, transferors use the Transfer of Education Benefits (TEB) website to designate, modify, and revoke a Transfer of Entitlement (TOE) request. After leaving the armed forces, transferors may provide a future effective date for use of TOE, modify the number of months transferred, or revoke entitlement transferred by submitting a written request to VA. Submit a TEB request now for your Service component approval (non-VA Link). (NOTE: When the milConnect Home page displays, select Education then Transfer of Education Benefits [TEB] from the menu bar.)

    Upon approval, family members may apply to use transferred benefits with VA by printing, completing, and mailing the VA Form 22-1990e to your nearest VA regional office of applying online. VA Form 22-1990e should only be completed and submitted to VA by the family member after DoD has approved the request for TEB. Do not use VA Form 22-1990e to apply for TEB.

    Other Factors to Consider

    • A childs subsequent marriage will not affect his or her eligibility to receive the educational benefit; however, after an individual has designated a child as a transferee under this section, the individual retains the right to revoke or modify the transfer at any time.
    • A subsequent divorce will not affect the transferees eligibility to receive educational benefits; however, after an individual has designated a spouse as a transferee under this section, the eligible individual retains the right to revoke or modify the transfer at any time.

    If a Servicemember wants to reallocate transferred benefits they can do so using the TEB Portlet in MilConnect at https://www.dmdc.osd.mil/milconnect. If a Veteran wants to reallocate benefits they should contact the VA using our “Ask A Question” website http://gibill.custhelp.com .

    If transferred benefits are totally revoked for a dependent a Servicemember must resubmimt a transfer request for the dependent via MilConnect, a Veteran cannot re-transfer benefits to a dependent if the dependent’s transfer eligibility was previously totally revoked.

    Family member use of transferred educational benefits is subject to the following rules:

    • May start to use the benefit immediately
    • May use the benefit while the member remains in the Armed Forces or after separation from active duty
    • Are not eligible for the monthly housing allowance while the member is serving on active duty
    • Can use the benefit for up to 15 years after the service members last separation from active duty
    • May start to use the benefit only after the individual making the transfer has completed at least 10 years of service in the armed forces
    • May use the benefit while the eligible individual remains in the armed forces or after separation from active duty
    • May not use the benefit until he or she has attained a secondary school diploma (or equivalency certificate), or he or she has reached age 18
    • Is entitled to the monthly housing allowance stipend even though the eligible individual is on active duty
    • Is not subject to the 15-year delimiting date, but may not use the benefit after reaching 26 years of age

    More Information

    • View the official DoD website for information on transferability (non-VA link)
    • Get the fact sheet on transferability of Post-9/11 GI Bill benefits
    • For specific questions about your eligibility, the status of your transfer request, and service specific questions about the TEB Portlet, please contact the appropriate career counselor or personnel center from the following list:




    Business proofreading services and copyediting #business #proofreading, #proofreading #services, #copyediting, #internet #proofreading,

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    Clients Love the Convenience, Speed, and Accuracy of
    Internet Proofreading from BusinessProofreading.com

    Internet Proofreading Is Convenient

    In this “I need it yesterday” world, you’re sure to agree with my clients that Internet proofreading is a blessing. The convenience of being able to simply email a message or attachment and have it returned to you polished and ready to impress is an absolute necessity. With Internet proofreading, all your copyediting can be handled quickly and professionally.

    “In the advertising/copywriting business, I always hear from customers who are in a hurry for copyediting. It’s such a blessing to know that BusinessProofreading.com is available to help me out in a pinch. The convenience factor of being able to email or fax a project to Cathy and have it returned in just a short while is a real lifesaver!”

    Internet Proofreading Is Fast

    I constantly hear my clients’ kind words about quick turnaround. Internet proofreading, in and of itself, speeds up the process. And I always strive to meet your deadlines even if you have a rush job.

    “Cathy Kessler has proven time and again to be a valuable asset in enhancing the effectiveness of many of my different types of written communications. I know that when I send something to Cathy for copyediting, not only will it be returned to me in a prompt manner, but also the document will be grammatically correct. Cathy’s helpful insights in the area of business proofreading have enabled me to clearly state what I want the reader to know, while doing it in a very straightforward, professional manner. I would highly recommend Cathy to anyone who understands the value of the well-edited written word.”

    Internet Proofreading Is Accurate

    Most of my clients rave about the accuracy of Internet proofreading. Because the copyediting is done in digital format, the results are more reliable than marking the changes on paper and then having to make adjustments on your document later. If you’d like to see the changes I’ve made while copyediting, just ask, and I’ll gladly mark them for you.

    “It’s really hard to find your own mistakes, especially when you know how text/copy should read. I always run all my projects past Cathy’s meticulous eyes before releasing a project to press or production. On more than one occasion, she has found typos or grammatical errors that would have cost me money and aggravation to reprint, not to mention client dissatisfaction as a result, I’ve never had to reprint a project. I would highly recommend Cathy’s copyediting and proofreading services to anyone who writes or uses text/copy of any kind. She’s the best!!”





    Cloud Computing Security Training, Certification – Institute of Information Security, Mumbai(India) #cloud

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    QUICK LINKS

    Cloud computing is the use of hardware and software resources that are delivered as a service typically over the Internet. It entrusts remote services with user’s data, software and computation.

    Although there are numerous business advantages and opportunities offered by cloud computing in terms of improved availability, scalability, flexibility etc. it is important to tap its business potential carefully. Securing the client data in the “cloud” must be the prime concern for the cloud service provider. Legal concerns over jurisdiction of client data in “cloud” needs to be addressed properly. This is because the stored data may not reside with service provider in its own data center or at a single location.

    In this course, we shall first discuss the characteristics of cloud computing and later on focus specifically on cloud security’s best practices taking reference from industry standards like NIST, OWASP, Cloud Security Alliance etc. We then look into the broad set of policies, technologies, and controls deployed to protect client data, applications and infrastructure associated with cloud computing.

    Who should attend?

    • Business Owners
    • Entrepreneurs
    • Senior Managers
    • Cloud solution providers
    • Business Analysts
    • Developers
    • Compliance managers
    • Security Enthusiasts

    Course Contents

    Session One: Cloud Knowledge Foundation
    • Introduction to cloud
    • History of Cloud Computing
    • Architectural Overview
    • Security Architecture
    • Terms & Terminologies
    • Cloud Deployment Types
      • Public Cloud
      • Private Cloud
      • Hybrid Cloud
      • Community Cloud
    • Service Model Types
      • Software As Service
      • Platform As Service
      • Infrastructure As Service
    • Some Real-world Cloud scenarios – Case Studies
    Session Two: Knowing Cloud Vendors – Demos




    Occupational Therapist Salaries by education, experience, location and more #occupational #therapist #schools

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    Occupational Therapist Salaries

    Alternate Job Titles: Occupational Therapist

    • What is the average annual salary for Occupational Therapist?

      How much does a Occupational Therapist make? The median annual Occupational Therapist salary is $82,628. as of May 30, 2017, with a range usually between $75,685 – $90,027. however this can vary widely depending on a variety of factors. Our team of Certified Compensation Professionals has analyzed survey data collected from thousands of HR departments at companies of all sizes and industries to present this range of annual salaries for people with the job title Occupational Therapist in the United States.

      This chart describes the expected percentage of people who perform the job of Occupational Therapist in the United States that make less than that annual salary. For example the median expected annual pay for a typical Occupational Therapist in the United States is $82,628, so 50% of the people who perform the job of Occupational Therapist in the United States are expected to make less than $82,628.

      Source: HR Reported data as of May 30, 2017

      • About this chart

        This chart describes the expected percentage of people who perform the job of Occupational Therapist that make less than that salary. For example 50% of the people who perform the job of Occupational Therapist are expected to make less than the median.
        Source: HR Reported data as of June 2017

        Plans and conducts individualized occupational therapy programs to help patients develop, regain, or maintain their ability to perform daily activities. Teaches patients skills/techniques and how to use adaptive equipment for participating in activities. Studies, evaluates, and records patients activities and progress. Requires a bachelor s degree and is certified as a occupational therapist. Familiar with standard concepts, practices, and procedures within a particular field. Relies on limited experience and judgment to plan and accomplish goals. Performs a variety of tasks. A certain degree of creativity and latitude is required. Typically reports to a manager. View full job description





    Consider hidden benefits of hospice – Journal News #homecare #hospice

    #benefits of hospice

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    Consider hidden benefits of hospice

    Kathie Campbell / Hospice of the Panhandle

    Think for a minute. Think about your family, friends, neighbors, co-workers. Think about the people with whom you go to church and the people you see in the grocery store. Think about those with whom you share a hobby or attend club meetings. Think about the people you meet at your children’s school. Of all those people – the people you relate to day in and day out – it is probable that at least one of them would benefit from hospice but is not receiving the service.

    In 2008, just 32 percent of all the people who died from end-stage illness in the Eastern Panhandle died under the care of hospice (45 percent of that one third had just one month of care or less). Close to 1,000 people died in Berkeley, Hampshire, Jefferson and Morgan counties in 2008 without any support from hospice.

    Think about this for another minute. Those nearly 1,000 people – people we know – suffered with the challenges of advanced disease alone, without the team of professionals and volunteers that cares for the patient while also supporting the family and caregivers. They never had access to the 24-hour, on-call support that would have prevented unnecessary trips to the emergency room or admissions to the hospital. They did not have the expert pain and symptom management from the hospice nurses and physicians. And they never reaped the financial benefit of hospice, a program that includes professional staff visits to the home, medicines, treatments, equipment, supplies, respite care, crisis care, hospitalization and bereavement care for the survivors – all fully covered by Medicare, Medicaid and most private insurers. All these people missed out on one of the best health care programs available today.

    The question is, “Why?”

    Why do people not take advantage of hospice at a time when it could make a huge difference in their living? Studies show that patients who access hospice earlier in the disease process actually live longer than expected. Ironically it seems that hospice, with its emphasis on quality of life, actually keeps people going. When people who are ill have good pain and symptom control and their caregivers are well supported, they don’t want to give up; they want to live longer.

    So think back again to all those people you know. Think about the ones who are coping with a serious, end-stage illness. Think about the friend who talks about caring for his wife or mother, who seems to be struggling to keep it all together, and as a result, is missing work or having his or her own health problems. Think about the person you know who needs more and more help with day-to-day activities. Consider the person who is in and out of the ER or hospital but nothing can be done to cure the illness. Think about those you know of advanced age who have grown thinner or weaker and are less able to care for themselves – and talk to these people about hospice.

    You may have a question about whether someone you know is a good fit for hospice. You don’t have to be a health care provider or even a family member to make a referral. We want you to call us to ask those questions. When you call you will talk to one of the Hospice of the Panhandle intake staff members who work out of our main office in Martinsburg. You can share the information you have, let us know the names of the patient and the patient’s doctor. Our staff will help sort out if hospice is the right service and can contact the physician with a referral. There is no obligation to enroll and no charge for us to answer a question or even to make an informational visit. There is absolutely nothing to lose by calling.

    You probably know someone right now who would benefit from hospice. If you have read this article you know there is no reason to delay. You have the information you need to help. If you don’t call, your friend might become one of the numbers we count next year as someone who could have had hospice but didn’t.

    You hold the key to hospice for someone you know. Use it.

    To reach the Hospice of the Panhandle intake department call (304) 264-0406 or (800) 345-6538.

    Lennox AC Units vs Trane AC Units: AC Review & Product Comparison

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    One constant reality about living in the Valley of the Sun is heat. With temperatures rising above the triple digit level virtually every day between May and September, ensuring your house or business is cooled by the best air conditioning unit possible is a reality that virtually every individual must deal with. But, among the two leaders in this industry, Lennox AC Units vs Trane AC Units. which is the best?

    Both Lennox and Trane offer their customers huge selections of high-quality AC units to choose from that are tailor-made to provide the service you individually need. Whether you are trying to cool a two-bedroom condo. or a 6-bedroom home or multiple room office, it is important to find the right AC Unit that will meet your needs best. And each company, Trane and Lennox offer superior quality units for multiple applications.

    Key Benefits of Lennox AC Units

    The Lennox AC Units are available to consumers in three major categories including:

    There are a total of (7) individual units available that are all Energy Star rated and have SEER Energy Ratings ranging from a low of 13 (for the Merit Series 13ACX Air Conditioning Unit) to a high of 21.2 (for the Dave Lennox Signature® Collection XC21 AC Unit). The Seasonal Energy Efficiency Ratio (SEER ) rating system was created by the United States Federal Government to provide consumers an easy and unified method of rating AC Units by terms of energy efficiency.

    Key Benefits of Trane® AC Units

    Trane® has a tag line that states, It s hard to stop a Trane® meaning, their units are build to last (and are exceptionally quiet). The Trane Air Conditioning Company provides consumers a total of (8) individual residential AC Units to choose from. These units, classified by their XL, XB and XR classifications range in SEER ratings from a low of 13 (in the XB300 Series AC Unit) to a high of 20.0 (in the XL20i AC Unit sold by Trane®). Trane offers customers exceptional quality, at very good pricing – similar to Lennox in many categories as well.

    Warranties Provided by Both Trane and Lennox AC Units

    Trane® offers their customers a 60 day limited warranty on all AC Units they sell. The warranty covers any manufactures defects on parts for a total of 10-years; which include both the coil and compressor. This warranty does not cover these parts for standard wear and tear, and requires that they unit be registered via phone or online. Trane® will replace parts; however the cost of installation and other materials is not covered by the manufacture.

    Lennox on the other hand is a bit more extended on their warranty coverage. They offer a 10-year warranty on parts, the compressor and the limited lifetime warranty on the heat exchanger for the Dave Lennox Signature Collection AC Units. The Elite Series offers a 5-year warranty plan on parts; 10-years for heat exchange and 20-years or ‘limited lifetime’ for other parts. The Merit Series is similar to the Elite Series.

    Both companies offer extended services plans through authorized dealers who install Lennox and Trane AC Units.

    View this brief presentation that highlights the Lennox vs Trane comparison:
    click the symbol at the bottom right to enable Full Screen mode.

    When choosing between each company, it is important to select the AC Unit that will fit your individual need best. As such, it is always advised to contact an authorized Trane or Scottsdale Lennox dealer and professional installation company who will provide expert advice and consultation for your AC Unit needs. To Get in touch with a certified Lennox Dealer in Scottsdale or Trane dealer in Scottsdale, we can help. Contact Scottsdale Air by calling 480-359-7141 today to get all of your questions answered, we are authorized Trane® and Lennox dealers.

    Contact the AC experts at Scottsdale Air Heating Cooling to replace your HVAC unit to keep your home cool. Email us or call 480-359-7141 now!

    Read related articles:

    http://www.scottsdaleair.com/wp-content/uploads/2015/08/scottsdale_logo4.png 0 0 Michael Cross http://www.scottsdaleair.com/wp-content/uploads/2015/08/scottsdale_logo4.png Michael Cross 2013-01-22 15:40:23 2016-11-07 19:57:35 Lennox AC Units vs Trane AC Units: AC Review & Product Comparison

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    MN Insurance Agent Minnesota Auto Car Homeowners Life Health Quote Columbia Heights

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    McAlpin Agency, Inc.

    Our Mission

    As an Independent Insurance Agency, it is our goal to provide you with the best coverage at the lowest price from a top quality company.

    To request a quote for MN insurance, click on the Quotes link above.
    Then choose the line of insurance from the Quote Forms menu that will appear.

    There are quote forms for Auto / Car, Homeowners, Health, Medicare Supplements, Medicare Advantage Plans, Medicare Part D Prescription Drug Plans, Life, Dental, Long-Term Care, Disability Income, Global / Travel Medical insurance, Employee Benefits, Commercial, Motorcycle, Watercraft (boats), Jet Ski (personal watercraft) Snowmobile.

    At McAlpin Agency, Inc. we are committed to protecting your privacy as a visitor to this Web site and as our customer. To our visitors and to our customers, we offer this pledge:

    McAlpin Agency, Inc. is the owner of the information, which is collected on this Web site. We will not sell, disseminate, disclose, trade, transmit, transfer, share, lease or rent any personally identifiable information to any third party not specifically authorized by you to receive your information except as we have disclosed to you in this Privacy Policy.

    Information Collection
    We will ask you to provide your personal information to us when you enroll for coverage and when you purchase an insurance policy from us. We will also ask you to provide your personal information to us when you send e-mail to us from this Web site. When you enroll for an insurance policy at McAlpin Agency, Inc. we will ask you to provide your name, home address, mailing address, telephone number and e-mail address. This information will be provided to the insurance company when you purchase an insurance policy so they can establish you as a policyholder. We will maintain a record of your information at the offices of McAlpin Agency, Inc. so we can provide you with policyholder service. The employees of McAlpin Agency, Inc. are each required to sign and acknowledge a Confidentiality And Nondisclosure Agreement. Each employee has been instructed on maintaining the privacy of each customer and the importance of protecting the customer’s personal information.
    When you purchase an insurance policy from McAlpin Agency, Inc. you will pay the premiums with your credit card or personal check. If you use your credit card to pay the premium, your credit card information is deleted from our records after your purchase has been authorized. A transaction number will be provided to you on your Binder Of Insurance. You may use this transaction number as a reference to the credit card purchase. We do not keep a record of your credit card information. If you pay the premium using your personal check, we will keep a copy of your check in your file.

    When you send us e-mail from this Web site, you will provide us with certain personally identifiable information including your e-mail address.

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    Changes In Our Privacy Policy
    We reserve the right to change this Privacy Policy without providing you with advance notice of our intent to make the changes.

    If you have any questions about our privacy policy, please feel free to contact us at:

    Statements on this web site as to policies and coverages provide general information only. This information is not an offer to sell insurance. Insurance coverage cannot be bound or changed via submission of any online form/application provided on this site or otherwise, e-mail, voice mail or facsimile. No binder, insurance policy, change, addition, and/or deletion to insurance coverage goes into effect unless and until confirmed directly by a licensed agent. Any proposal of insurance we may present to you will be based upon the information you provide to us via this online form/application and/or in other communications with us. Please contact our office at [insert phone number] to discuss specific coverage details and your insurance needs. All coverages are subject to the terms, conditions and exclusions of the actual policy issued. Not all policies or coverages are available in every state. Information provided on this site does not constitute professional advice; if you have legal, tax or financial planning questions, you should contact an appropriate professional. Any hypertext links to other sites are provided as a convenience only; we have no control over those sites and do not endorse or guarantee any information provided by those sites.

    Personal Lines Insurance





    Palliative chemotherapy: harms and benefits weighed in new study – Medical News

    #palliative chemotherapy

    #

    Palliative chemotherapy: harms and benefits weighed in new study

    Palliative chemotherapy is treatment designed for terminal cancer patients to prolong survival and ease symptoms but not cure disease. Now, researchers have found that the therapy comes with certain harms, which they say need to be addressed.

    The researchers, from the Weill Cornell Medical College, Dana-Farber Cancer Institute and Harvard Medical School, have published their results in the BMJ.

    They say their findings uncover a discrepancy between what type of care cancer patients want and what they actually receive.

    Overall, the team found that terminal cancer patients who receive chemotherapy during the last months of their lives are less likely to die where they wish and are more likely to undergo invasive medical procedures – including CPR and mechanical ventilation – than patients who did not receive the therapy.

    Dr. Holly Prigerson, of Weill Cornell Medical College, says that the reasons for the link are complicated, but they may originate in misunderstanding of the purpose and consequences of palliative chemotherapy.

    For the study, investigators assessed data from 386 patients in a federally funded study, called Coping with Cancer.

    This 6-year study followed terminally ill people and their caregivers until the patients died, and the researchers looked at how psychosocial factors influenced patient care.

    After asking the caregivers to rate their patient’s care, quality of life and where the patient would have wanted to die, the researchers reviewed patient medical charts to determine the type of care they actually received during their last week.

    Chemotherapy patients less likely to die where they want

    The researchers found that patients receiving palliative chemotherapy were less likely to talk to their oncologists about the type of care they wanted to receive, to complete Do-Not-Resuscitate orders or to even acknowledge they were terminally ill.

    The findings reveal that 68% of patients receiving palliative chemotherapy died where they wanted, compared with 80% of those not receiving the therapy.

    In detail, 47% of patients who received the therapy died at home, compared with 66% of patients who did not receive the palliative care. Additionally, 11% of patients receiving the chemotherapy died in an intensive care unit, versus only 2% of patients not receiving the therapy.

    Dr. Prigerson says:

    “It’s hard to see in these data much of a silver lining to palliative chemotherapy for patients in the terminal stage of their cancer. Until now, there hasn’t been evidence of harmful effects of palliative chemotherapy in the last few months of life.”

    “This study is a first step in proving evidence that specifically demonstrates what negative outcomes may result,” she adds.

    The team also found that patients receiving palliative chemotherapy were more likely to be referred to hospice care much later than those not receiving the therapy.

    Hospice care is a place that provides comfort and emotional support for terminal patients, and 54% of the patients receiving chemotherapy were referred to hospice late, compared with 37% of the patients not receiving the drugs.

    ‘Potential need for oncology practice changes’

    The team notes that 56% of the patients from the study were receiving palliative chemotherapy in their final months, and they say this majority of use emphasizes the potential need for changes in oncology practice at academic medical centers.

    Dr. Alexi Wright, assistant professor and medical oncologist at Dana-Farber, says:

    “We often wait until patients stop chemotherapy before asking them about where and how they want to die, but this study shows we need to ask patients about their preferences while they are receiving chemotherapy to ensure they receive the kind of care they want near death.”

    But Dr. Wright adds that their findings should not be interpreted that patients should be denied or not offered palliative chemotherapy:

    “The vast majority of patients in this study wanted palliative chemotherapy if it might increase their survival by as little as a week. This study is a step towards understanding some of the human costs and benefits of palliative chemotherapy.”

    “Additional studies are needed to confirm these troubling findings,” concludes Dr. Prigerson.

    Car Donation BENEFITS of Vehicle Donations #benefits #of #donating #a #car, #car

    #

    Car Donation benefits – Why donate a vehicle

    Here are just a few of the benefits you will receive by supporting the Charitable causes and benevolent programs made available through Online Car Donation :

    Car donations are much easier than trying to sell or trade in vehicles by yourself!

    When you donate a vehicle. you avoid all of the hassles associated with selling a vehicle. No haggling with a dealer over the trade-in value. No waiting at home for the phone to ring or for people to come to look at the car. No advertising costs associated with selling the vehicle and In some cases the financial benefits of giving overshadow the benefits of selling your used vehicle.
    (The car donation procedure is quick, simple and completely hassle free (Online Car Donation handles everything for you )
    We can go on, but we feel confident almost everyone should get the point that it is much easier to just donate car .

    Feel good about benefiting worthy and charitable causes worldwide and truly helping those in need of a helping hand.

    Remember, it’s always better to give than receive. The glory and most important benefit of charity donations is that you give and receive at the same time. Unlike other so called car donation programs, Online Car Donation does not spend your donation dollars on expensive advertising, leaving those that need help with pennies. Instead we maximize your donation dollars and concentrate on actually helping solve the many pressing world issues our world is currently experiencing. Some causes your car donation supports include: disorder and disease prevention such as Muscular Dystrophy, Leukemia, cancer and aids research. The millions of starving and homeless children under the age of 5 worldwide. The rising cases of Asperger’s Autism where 1 in 150 children in the United States have been diagnosed. We do not limit our support to world issues only though. We also concentrate on our communities and every chance we have to repair a vehicle and give to a family that is in need, we gladly help them out. Online Car Donation Cares!

    Eligibility for a Fair Market Value tax deduction.

    We can refer you to IRS Form 4303 which requires you to personally determine the value of your car donation. vehicle donations or property donation. You can review this IRS publication 4303 right now. In many cases you shall receive a fair market value tax write-off because Online Car Donation repairs the vehicle and gifts to a family in need of dependable transportation. In other cases we offer your vehicle as a gift to extremely generous donors which in turn entitles you to a fair market value tax deduction. This is why we are #1 !

    Enjoy a Free Vacation!

    If you were ever looking for a reason to donate a vehicle. now is the time to take advantage of this exciting offer!
    We have affiliated with a leading vacation travel company that has gifted us thousands of deluxe vacation offerings!

    Any vehicle donation valued over $500 you complete with us entitles you to a voucher allowing you to choose from 4 different deluxe vacation packages. No timeshare seminar or sales pitches of any kind! Your reservation must be taken with 1 year.
    You will receive deluxe hotel accommodations in the city you choose. This is the least we can offer as our gift to you for your generosity.

    Easier, cheaper and safer than fixing the car yourself.

    Online Car Donation offers free towing nationwide and more often than not has the entire car donation process from start to finish completed in 48 hours. Save yourself the trouble and possible cuts and bruises while trying to repair your vehicle yourself. Or keep your wallet fatter and stop spending more money than the car is worth on repairs and more repairs and more repairs.

    You can make a difference with your vehicle donation – donate cars to charity





    Palliative chemotherapy: harms and benefits weighed in new study – Medical News

    #palliative chemotherapy

    #

    Palliative chemotherapy: harms and benefits weighed in new study

    Palliative chemotherapy is treatment designed for terminal cancer patients to prolong survival and ease symptoms but not cure disease. Now, researchers have found that the therapy comes with certain harms, which they say need to be addressed.

    The researchers, from the Weill Cornell Medical College, Dana-Farber Cancer Institute and Harvard Medical School, have published their results in the BMJ.

    They say their findings uncover a discrepancy between what type of care cancer patients want and what they actually receive.

    Overall, the team found that terminal cancer patients who receive chemotherapy during the last months of their lives are less likely to die where they wish and are more likely to undergo invasive medical procedures – including CPR and mechanical ventilation – than patients who did not receive the therapy.

    Dr. Holly Prigerson, of Weill Cornell Medical College, says that the reasons for the link are complicated, but they may originate in misunderstanding of the purpose and consequences of palliative chemotherapy.

    For the study, investigators assessed data from 386 patients in a federally funded study, called Coping with Cancer.

    This 6-year study followed terminally ill people and their caregivers until the patients died, and the researchers looked at how psychosocial factors influenced patient care.

    After asking the caregivers to rate their patient’s care, quality of life and where the patient would have wanted to die, the researchers reviewed patient medical charts to determine the type of care they actually received during their last week.

    Chemotherapy patients less likely to die where they want

    The researchers found that patients receiving palliative chemotherapy were less likely to talk to their oncologists about the type of care they wanted to receive, to complete Do-Not-Resuscitate orders or to even acknowledge they were terminally ill.

    The findings reveal that 68% of patients receiving palliative chemotherapy died where they wanted, compared with 80% of those not receiving the therapy.

    In detail, 47% of patients who received the therapy died at home, compared with 66% of patients who did not receive the palliative care. Additionally, 11% of patients receiving the chemotherapy died in an intensive care unit, versus only 2% of patients not receiving the therapy.

    Dr. Prigerson says:

    “It’s hard to see in these data much of a silver lining to palliative chemotherapy for patients in the terminal stage of their cancer. Until now, there hasn’t been evidence of harmful effects of palliative chemotherapy in the last few months of life.”

    “This study is a first step in proving evidence that specifically demonstrates what negative outcomes may result,” she adds.

    The team also found that patients receiving palliative chemotherapy were more likely to be referred to hospice care much later than those not receiving the therapy.

    Hospice care is a place that provides comfort and emotional support for terminal patients, and 54% of the patients receiving chemotherapy were referred to hospice late, compared with 37% of the patients not receiving the drugs.

    ‘Potential need for oncology practice changes’

    The team notes that 56% of the patients from the study were receiving palliative chemotherapy in their final months, and they say this majority of use emphasizes the potential need for changes in oncology practice at academic medical centers.

    Dr. Alexi Wright, assistant professor and medical oncologist at Dana-Farber, says:

    “We often wait until patients stop chemotherapy before asking them about where and how they want to die, but this study shows we need to ask patients about their preferences while they are receiving chemotherapy to ensure they receive the kind of care they want near death.”

    But Dr. Wright adds that their findings should not be interpreted that patients should be denied or not offered palliative chemotherapy:

    “The vast majority of patients in this study wanted palliative chemotherapy if it might increase their survival by as little as a week. This study is a step towards understanding some of the human costs and benefits of palliative chemotherapy.”

    “Additional studies are needed to confirm these troubling findings,” concludes Dr. Prigerson.

    Home Healthcare – Health Benefits #hotels #dublin

    #home health agencies

    #

    Health Benefits

    Home Healthcare

    Home Health Care includes VA’s Skilled Home Health Care Services (SHHC) and Homemaker and Home Health Aide Services (H/HHA).

    Skilled Home Health Care (SHHC) Services

    SHHC is short-term health care services that can be provided to Veterans if they are homebound or live far away from VA. The care is delivered by a community-based home health agency that has a contract with VA. SHHC is for Veterans who need skilled services, case management, and assistance with activities of daily living (e.g. bathing and getting dressed) or instrumental activities of daily living (e.g. fixing meals and taking medicines); are isolated or their caregiver is experiencing burden.

    Homemaker/Home Health Aide (H/HHA) Services

    The services of a Homemaker or Home Health Aide can help Veterans remain living in their own home and can serve Veterans of any age. A Homemaker or Home Health Aide can be used as a part of an alternative to nursing home care, and as a way to get Respite Care at home for Veterans and their family caregiver.

    VA’s Family Caregivers Program provides support and assistance to caregivers of post 9/11 Veterans and Service Members being medically discharged. Eligible primary Family Caregivers can receive a stipend, training, mental health services, travel and lodging reimbursement, and access to health insurance if they are not already under a health care plan. For more information, contact your local VA medical facility and speak with a Caregiver Support Coordinator, visit www.caregiver.va.gov or dial toll-free 1-877-222-VETS (8387).

    Home Telehealth

    Home Telehealth, also known as Care Coordination/Home Telehealth, is a service that allows the Veteran’s physician or nurse to monitor the Veteran’s medical condition remotely using home monitoring equipment.

    Veterans can be referred to a care coordinator for Home Telehealth services by any member of their care team.

    When approved for Home Telehealth, specialized equipment in the Veteran’s home will provide the care coordinator with the Veteran’s health information. The care coordinator will check in with the Veteran by phone, if needed. If any of the Veteran’s health measurements do not seem normal, the care coordinator talks with their physician or nurse and then gets back to the Veteran with next steps.

    Hospice Benefits #glasgow #hotels

    #medicare hospice benefit

    #

    Hospice Benefits

    The Hospice benefit is an optional state plan service that includes an array of services furnished to terminally ill individuals. These services include: nursing, medical social services, physician services, counseling services to the terminally ill individual and the family members or others caring for the individual at home, short-term inpatient care, medical appliances and supplies, home health aide and homemaker services, physical therapy, occupational therapy and speech-language pathology services.

    Individuals must elect the hospice benefit by filing an election statement with a particular hospice. They must acknowledge that they understand that other Medicaid services for the cure or treatment of the terminal condition are waived. Individuals may, however, revoke the election of hospice at any time and resume receipt of the Medicaid-covered benefits waived when hospice was elected.

    A hospice provider must obtain a physician certification that an individual is terminally ill and hospice services must be reasonable and necessary for the palliation or management of the terminal illness and related conditions. A hospice plan of care must be established before services are provided.

    Payment for hospice services is made to a designated hospice provider using the CMS annually published Medicaid hospice rates that are effective from October 1 of each year through Sept 30 of the following year. With the exception of payment for physician services Medicaid reimbursement for hospice care will be made at predetermined rates for each day the individual receives care under one of the following categories or levels of hospice care:

    1. Routine Home Care, (RHC), Hospice Providers are paid one of two levels of (RHC), effective for dates of service on or after January 1, 2016. This two-rate payment methodology will result in a higher RHC rate based on payment for days one (1) through sixty (60) of hospice care and a lower RHC rate for days sixty one (61) or later. A minimum of sixty (60) day’s gap in hospice services is required to reset the counter that determines which payment category a participant is qualified for.;
    2. Continuous Home Care, (CHC), which is furnished during a period of crisis and primarily consists of nursing care;
    3. Inpatient Respite Care, (IRC), which is short-term care and intended to relieve family members or others caring for the individual; and
    4. General Inpatient Care, (GIC), which is short term and intended for pain control or acute or chronic symptom management which cannot be provided in other settings.
    5. Effective January 1, 2016, Service Intensity Add-On which provides that hospice services are eligible for an end-of life service intensity add on payment when the following criteria are met:
      1. The day on which the services are provided is an RHC level of care;
      2. The day on which the service is provided occurs during the last seven days of life, and the client is discharged deceased;
      3. The service is provided by a registered nurse or social worker that day for at least fifteen minutes and up to four hours total and
      4. The service is not provided by the social worker via telephone.

    The national hospice reimbursement rates for these four levels of care change annually. Medicaid Hospice Rates for federal Fiscal Year (FY) 2017 are based on the annual Medicare changes and are typically a little higher due to offsets attributable to Medicare coinsurance amounts.

    Beginning March 23, 2010, with the enactment of the Affordable Care Act, Medicaid and CHIP-eligible individuals under age 21 who elect the hospice benefit no longer have to waive services for the cure or treatment of the terminal condition and can receive both curative care and hospice care for the terminal condition.

    Benefits of Hospice Care #hospice #job #vacancies

    #benefits of hospice

    #

    The New York Times

    Benefits of Hospice Care

    April 17, 2014

    Having just recently placed both my parents in long-term care for advancing dementia, I read Janet Steen’s April 13 Sunday Review essay, “My Mother’s Keepers ,” with great empathy. Her article showed the struggle, the guilt and the financial commitment that Alzheimer’s disease has on the family and the person suffering from this debilitating and ultimately fatal disease.

    I am impressed by the creative way she and her family cared for their mother and the enormous trust they placed in a stranger. I applaud the love and professionalism of a caregiver like Ramona.

    I am also a hospice nurse and wonder why the family apparently did not enroll their mother in hospice care. Her physical, emotional, spiritual and psychological needs would have been met quickly and effectively by the hospice team, avoiding the need for repeated hospital visits and the final and devastating admission to the intensive care unit.

    Her mother’s hospice benefit under Medicare would have paid for visits to Ramona’s home by a registered nurse who specializes in end-of-life care and comfort medications. Ramona and all those involved in Ms. Steen’s mother’s care would have been instructed on how to treat and manage symptoms. Her mother would have been able to die at home in a warm, familiar environment, surrounded by those who loved her and cared for her.

    Hospice and palliative care not only improve the care of the patient but also lessen the need for disruptive, expensive and futile treatment.

    CAROL HOLGUIN
    Edina, Minn. April 13, 2014

    We’re interested in your feedback on this page. Tell us what you think.

    Medicare Benefits – Getting Starrted #hamilton #motel

    #medicare hospice benefits

    #

    Medicare Hospice Benefits – Getting Started

    Medicare hospice benefits
    Hospice is a program of care and support for people who are terminally ill. Here are some important facts about hospice:

    • Hospice helps people who are terminally ill live comfortably.
    • Hospice isn’t only for people with cancer.
    • The focus is on comfort, not on curing an illness.
    • A specially trained team of professionals and caregivers provide care for the “whole person,” including your physical, emotional, social, and spiritual needs.
    • Services may include physical care, counseling, prescription drugs, equipment, and supplies for the terminal illness and related conditions.
    • Care is generally provided in the home.
    • Family caregivers can get support.

    Important: The hospice program you choose must be Medicare approved to get Medicare payment.

    If you have Medicare Part A (Hospital Insurance) AND meet these conditions, you can get hospice care:

    • Your regular doctor and the hospice medical director certify that you’re terminally ill (with a life expectancy of 6 months or less.)
    • You accept palliative care (for comfort) instead of care to cure your illness.
    • You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness and related conditions.

    Hospice care is given in benefit periods. You can get hospice care for two 90-day periods followed by an unlimited number of 60-day periods. At the start of each period, the hospice medical director and your doctor must recertify that you’re terminally ill, (with a life expectancy of 6 months or less), so you can continue to get hospice care. You have the right to change providers once during each benefit period.

    You always have the right to stop hospice care at any time for any reason. If you stop your hospice care, you’ll get the type of Medicare coverage you had before you chose a hospice program (like treatment to cure terminal illness.). If you’re eligible, you can go back to hospice care at any time.

    What’s covered?
    Hospice care is usually given in your home. Depending on your terminal illness and related conditions, the plan of care your hospice team creates can include any or all of these services:

    • Doctor services
    • Nursing care
    • Medical equipment (like wheelchairs or walkers)
    • Medical supplies (like bandages and catheters)
    • Prescription drugs
    • Hospice aide and homemaker services
    • Physical and occupational therapy
    • Speech-language pathology services
    • Social worker services
    • Dietary counseling
    • Grief and loss counseling for you and your family
    • Short-term inpatient care (for pain and symptom management)
    • Short-term respite care – If your usual caregiver (like a family member) needs a rest, you can get inpatient respite care in a Medicare-approved facility (like a hospice inpatient facility, hospital, or nursing home). Your hospice provider will arrange this for you.
    • Any other Medicare-covered services needed to manage your pain and other symptoms that are part of your terminal illness and related conditions, as recommended by your hospice team. If your usual caregiver (like a family member) needs a rest, you can get inpatient respite care in a Medicare-approved facility (like a hospice inpatient facility, hospital, or nursing home). Your hospice provider will arrange this for you.

    Important: Once you choose hospice care, your hospice benefit should generally cover everything you need. Original Medicare will still pay for covered benefits for any health problems that aren’t part of your terminal illness and related conditions, but this is very rare.

    What do I pay?
    You’ll pay:

    • A copayment of up to $5 per prescription for outpatient prescription drugs for pain and symptom management. In the rare case your drug isn’t covered by the hospice benefit, your hospice provider should contact your Medicare drug plan to see if it’s covered under Medicare prescription drug coverage (Part D).
    • 5% of the Medicare-approved amount for inpatient respite care.

    All Medicare-covered services you get while in hospice care are covered under Original Medicare, even if you were previously in a Medicare Advantage Plan (like an HMO or PPO) or other Medicare health plan.

    Note: If your Medicare Advantage Plan or other Medicare health plan covers extra services that Original Medicare doesn’t cover (like dental and vision benefits), your plan will continue to cover these extra services while you’re in hospice care (as long as you continue to pay your premium).

    Your Medicare rights
    People with Medicare have certain guaranteed rights. If your hospice program or doctor believes that you’re no longer eligible for hospice care because your condition has improved—and you don’t agree—you have the right to ask for a review of your case.

    Your hospice should give you a notice that explains your right to an expedited (fast) review by an independent reviewer hired by Medicare, called a Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO). If you don’t get this notice, ask for it. This notice lists your BFCC-QIO’s contact information and explains your rights.

    You can also visit Medicare.gov/contacts. or call 1-800-MEDICARE (1-800-633-4227) to get the phone number for your BFCC-QIO. TTY users should call 1-877-486-2048.

    Note: If you pay out-of-pocket for an item or service your doctor ordered, but the hospice refuses to give it to you, you can file a claim with Medicare. If your claim is denied, you can file an appeal.

    For more information on appeals, visit Medicare.gov/appeals or call 1-800-MEDICARE.

    For information about how to file a complaint about the hospice that’s providing your care, visit Medicare.gov/claims-and-appeals/file-a-complaint/complaints.html or call 1-800-MEDICARE.

    “Medicare Hospice Benefits: Getting Started” isn’t a legal document. More details are available atMedicare.gov/publications. Official Medicare Program legal guidance is contained in the relevant statutes, regulations, and rulings