Hospice of the Bluegrass is now Bluegrass Care

Hospice of the Bluegrass is now …. . Bluegrass Care Navigators

Explanation of Name Change Having cared for thousands of families in our communities since 1978, we’ve been expanding our service offerings and have outgrown our name. We now provide expert care long before life’s final months. We changed our name to Bluegrass Care Navigators to guide and provide care to more people in more ways at earlier stages of serious illness. Yet, we’re still the same great provider with the same great people. We still have the same compassion and commitment that has always defined Hospice of the Bluegrass. We now have a new name to reflect our growing range of services.

Our Service Offerings

Bluegrass Care Navigators at a Glance 2016 Stats Bluegrass Care Navigators Employees: 522 Bluegrass Hospice Care Volunteers: 752 Bluegrass Hospice Care Average Daily Census: 710 Bluegrass Hospice Care Patients Served: 5254 Bluegrass Extra Care Employees: 95 Bluegrass Extra Care Patients Served: 39 Bluegrass Transitional Care Patients Served: 3, 730

Conditions of Participation Requirement: • As a result of being a contracted vendor w/ Bluegrass Hospice Care, a service of Bluegrass Care Navigators, we are required to provide an annual orientation about hospice philosophy to all employees and contracted staff. § 418. 100 Condition of Participation: Organization and administration of services. (2) The hospice must continually monitor and manage all services provided at all of its locations to ensure that services are delivered in a safe and effective manner and to ensure that each patient and family receives the necessary care and services outlined in the plan of care, in accordance with the requirements of this subpart and sub- parts A and C of this section. (g) Standard: Training. (1) A hospice must provide orientation about the hospice philosophy to all employees and contracted staff who have patient and family contact. (2) A hospice must provide an initial orientation for each employee that addresses the employee’s specific job duties. (3) A hospice must assess the skills and competence of all individuals furnishing care, including volunteers furnishing services, and, as necessary, provide inservice training and education programs where required. The hospice must have written policies and procedures describing its method(s) of assessment of competency and maintain a written description of the inservice training provided during the previous 12 months. • The following slides are provided for your review to meet this requirement.

Bluegrass Hospice Care 2017 Vendor In-Service

What is Bluegrass Hospice Care? • • • A private non-profit organization governed by a volunteer Board of Directors. A member of the National Hospice and Palliative Care Organization. Certified by Medicare, Medicaid and The Joint Commission. Licensed by the State of Kentucky. A member of the Center to Advance Palliative Care Serving patients and their families in 32 counties in central, southeastern and northern Kentucky for over 35 years.

Bluegrass Hospice Care at a Glance • 6 office locations serving 10, 000 square miles – Northern KY – Cynthiana – Frankfort – Lexington – Barbourville – Hazard • 2 in-patient facilities Ø Lexington – 12 beds ØLocated inside KY One/St. Joseph Hospital Ø Hazard – 6 beds ØFree standing Hospice House

Service Area Map

Our Mission Providing patient-centered care to the seriously ill and their families with excellence and compassion; engaging in community partnerships, education and counseling; offering opportunities to staff, volunteers and donors to enrich lives through their gifts.

Our Vision Be the leader in delivering comforting care at the right time to the seriously ill.

Our Core Values Compassion Excellence Teamwork Respect & Dignity Diversity Integrity Innovation Sustainability

Who Benefits? 1. Patient 2. Family 3. Referring provider When the burden of treatment for any disease is outweighing quality of life, hospice care services provide unique medical, emotional and spiritual support for the patient and their family. You play an important role in providing your patients with choices for end-of-life care!

Hospice Affirms Life • • • Bluegrass Hospice Care exists to provide support and care for persons in the last phase of life so that they can live as fully and comfortably as possible. Dying is recognized as a normal process and is neither hastened nor postponed. Hospice is not a place but a concept of care, and exists in the hope and belief that through compassionate care patients and families may be free to attain a level of mental and spiritual preparation for death that feels good to them.

Understanding Hospice Care • • Hospice is a benefit program for individuals with a terminal prognosis. Hospice care is provided under the direction of a physician. Focus: o Hospice focuses on treating the person rather than the disease. Goals: o o Hospice works to treat bothersome symptoms. Hospice works to enhance a patient’s quality of life while supporting the patient’s family.

Evidence for Hospice Care • Pain and symptoms are better managed with palliative and/or hospice services. • Higher or enhanced quality of life. • Improved caregiver well-being (support, advice, counseling). • Less depressive scores in the bereaved. • Medical care consistent with patient’s wishes. • Hospice and palliative care under-utilized services. • Hospice and Palliative care is a cost-savings to the healthcare delivery system

How do I know when a patient may be eligible for Hospice Care? • When patients are not responding to therapies or all curative therapies have been exhausted. • You see a major decline from the patient’s last visit. • Increased number of hospitalizations over the last year. • Readmitted with similar symptoms with the last three months. • Caregivers are expressing difficulty in managing the patient’s care at home.

End-of-life goals When a person indicates they wish to have the following end-oflife goals they may be eligible for Hospice care: • Avoid hospitalizations. • Avoid unnecessary procedures. • Minimize pain. • Remain lucid/functional. • Be surrounded by family and friends • Participate in religious services and/or activities they value and enjoy.

Admission Criteria and Eligibility • • Patients presenting with a terminal prognosis with six months or less to live if the disease progresses as expected. Patients are no longer undergoing or seeking curative therapies. Any age, with any progressive illness. A physician is willing to be an attending physician and certify that the patient has a prognosis of six months or less to live if the disease runs its normal course.

Common Diagnoses • Pulmonary Disease • Kidney disease – End stage renal failure • Liver Disease • Alzheimer’s • Dementia • • Stroke/Coma HIV/AIDS Heart Disease ALS/Chronic Degenerative Neuro Disease • Cancer

Who Pays for Hospice Care? Hospice care is a benefit provided by: • • Medicare Medicaid Most private insurance providers and The Department of Veterans Affairs. No one is ever denied care because of an inability to pay thanks to the support of donations from generous individuals, corporations, foundations and organizations who help pay these costs.

Understanding the Referral Process • • ANYONE can start the referral process Bluegrass Hospice Care receives referrals from: • • • Hospitals Physicians Nursing Homes Patients themselves Family and friends of the patient Assisted living facilities Veterans organizations Home health and other providers Ministers

Bluegrass Hospice Care Services are: Provided to patients meeting admission criteria without regard to race, color, national origin, age, sex, mental or physical disability, religion or income level.

What happens after a referral is made? • Once Bluegrass Hospice Care receives a referral, Hospice staff will contact the patient’s personal physician to see if the patient is: – – Eligible for admission with a terminal prognosis and Whether the physician will agree to be the patient’s hospice attending physician. • Bluegrass Hospice Care staff will then contact the patient and or their family or caregiver to set up a time to meet with them and explain our services. • Finally, a hospice interdisciplinary team will complete a comprehensive assessment of the patient /family needs.

Hospice Services: • • • Provides an interdisciplinary team of highly trained professionals who work closely with patients and families to enhance quality of life. Teams visit wherever the patient resides - this may be their home, nursing homes, hospitals, veterans and assisted living facilities. Difficult symptom and pain relief. Medications, medical equipment and supplies (related to the terminal diagnosis). Bereavement Services (individual and group counseling)

Hospice Services provide: • • • Physical, emotional and spiritual support. Grief and bereavement services for patients and their entire family. Family support and education for caregivers. Respite and volunteer assistance. Hospice in-patient care center services (for respite symptom management). Medications, equipment and medical supplies (related to the terminal diagnosis).

Where do we see our patients? Bluegrass Hospice Care services are provided wherever a patient resides: Ø Ø Homes. Nursing homes. Hospitals. Veterans and assisted living facilities. Bluegrass Hospice Care also provides inpatient , respite and pain management care at the following in-patient units: Ø The Hospice Care Center at St. Joseph’s Hospital in Lexington, Kentucky Ø The Greg & Noreen Wells Hospice Care Center in Hazard, Kentucky

Who will help? The Hospice Team Bluegrass Hospice Care uses an interdisciplinary team of experts to care for a patient and their family. The team includes: ü The patient and their family – the patient and family helps direct the patient’s plan of care while they are a patient of Bluegrass Hospice Care. ü Medical Directors/Physicians – who specialize in managing pain and other bothersome symptoms such as depression, anxiety, nausea and shortness of breath.

More team members: • • Nurses - who visit the patient regularly in their home or residence to ensure the patient is comfortable, educate the caregiver about what to expect and how to care for the patient. Available 24 hours a day. Social Workers – who provide counseling to the patient and connect them to any available resources in the community (advanced directives, insurance, benefits). Chaplains – who provide spiritual support to the patient, family and caregivers. Pray, listen and administer sacraments. Certified Nursing Assistants – who can assist with bathing, dressing and other activities of daily living.

And even more… • • • Bereavement Counselors – who provide individual and group grief counseling to the family after a patient dies. Helps family with anticipatory grief. DME Drivers – who deliver medications and set up medical equipment for the patient. Volunteers – who provide practical support to the patient and family (read, provide transportation to appointments sit with patients, socialize and provide respite care for the caregiver).

Other Programs of Bluegrass Care Navigators

Bluegrass Palliative Care A physician consult service providing specialized medical care focused on providing relief from the symptoms and stresses of a serious illness, all with the goal of improving quality of life.

Bluegrass Extra Care A private pay, personalized service for clients in their home, nursing or assisted living facility. Services can include homemaker/companionship, certified nursing assistants, sitters and skilled nursing.