Frequently Asked Questions: Hospice Care
BECOMING A RESIDENT
What is hospice and how do I know if I'm eligible?
Hospice is a philosophy of care focused on comfort versus curing. Please refer to our Hospice Resource section to learn more.
Do you have to be a Buddhist to be served by Zen Hospice?
No. Our residents are not necessarily Buddhist and don’t necessarily come to us because we are a Buddhist hospice. They come to us simply because they need a place where they can receive excellent care at the end of their lives. Our approach to end-of-life care is grounded in the Buddhist tradition, but we welcome people from culturally and spiritually diverse backgrounds. As caregivers we honor our residents’ religious traditions—and how these shape their dying process. Services are provided regardless of religious or sexual preference, gender, ethnicity, age, national origin, or financial resources.
Where is the Guest House located?
The Guest House is located at 273 Page Street, San Francisco, CA, 94102. It is near the corner of Page and Laguna, in the heart of the Hayes Valley neighborhood. Click here for directions.
Is the Guest House wheelchair accessible?
Yes. A wheelchair entrance and wheelchair extensions make all indoor and outdoor areas easily accessible. Spaciousness, wide doorways, bathroom access, and an elevator assure full mobility throughout the house.
Do you have space?
Availability at the Guest House changes on a daily basis. Since there are several factors that guide the admissions process, it is best to begin at our Admissions page and follow the steps presented there.
How do I apply to live at the Guest House?
Click here for full details including our Admissions Application.
Who do I contact to discuss admissions?
Call 415-913-7682 to reach Guest House Intake Staff regarding admissions and to discuss a person’s suitability for the Guest House residence.
What are your criteria for admissions?
Click here for our Admissions Criteria; they are also listed in the Admissions Application.
Do you accept residents from outside the Bay Area?
In general, we accept only San Francisco Bay Area residents. If you live outside the Bay Area, we suggest you contact the National Hospice and Palliative Care Organization at 800-658-8898. They will help you find hospice services in your area. On occasion we might accept an out-of-state resident, but they would need to have a local physician caring for them. Read our full admissions policies here.
Do you take patients with dementia/Alzheimer’s?
Our license restricts us from accepting residents with a primary diagnosis of Alzheimer’s. Given the complex and specialized care often required for dementia and Alzheimer’s patients, consideration for admission would be on a case-by-case basis. In general, patients with a high level of need would be asked to have additional support from outside caregivers to assure the safety of themselves and others. Our staff are available to assist in arranging this additional support.
Are any other languages spoken?
Although the primary language of the facility is English, Zen Hospice Project will make every effort to accommodate individuals who speak languages other than English and provide translation services.
Do you allow or encourage assisted suicide?
No. Physician-assisted suicide remains illegal in California and we abide by the law. In our experience, the issue of physician-assisted suicide often arises as a response to a complex set of problems. We seek to help people sort through and address those problems one-by-one, instead.
COSTS, INSURANCE, ETC.
How much does it cost?
The rate for custodial care (room and board) at the Guest House is based on a sliding scale rate and evaluation by our intake staff. The Guest House has a dual-fee structure. Residents will be charged separately for: (1) room and board payable to Zen Hospice Project; and (2) hospice care payable to the resident's own hospice provider (including nursing, social worker, attendant/home care aide, and rehabilitation services). Charges for room and board are billed directly to the resident. Medicare, Medi-Cal, and most private insurances will not reimburse for these charges. The resident is responsible for any portion of the bill not covered by the third-party payer.
How can I apply Medicare or insurance to the fee?
Because we are licensed as a Residential Care Facility for the Chronically Ill (RCF-CI), we generally fall outside the coverage provided by Medicare or other insurance programs. Although hospice services are covered by these programs, the daily rate for the custodial care (room and board) is not. On occasion, reimbursement from long-term care insurance is possible, but each plan has its restrictions. Intake staff will help determine what, if any, coverage is available.
What’s the average length of stay? Maximum stay?
The average length of stay for end-of-life is hard to determine. In general, hospice enrollment requires a diagnosis of six-month or less to live. This is more a guideline than a fixed point in time. If at six months, the resident is still alive, then a re-evaluation of their condition is done. From this, they may qualify to remain on hospice for an additional period of time which is evaluated every three months. As long as a resident is hospice-appropriate and meets other general requirements, there is not a maximum stay. If a resident no longer needs hospice services, it is most likely that the resident will be asked to leave the Guest House. If hospice is reinstated, that individual would be eligible for re-admission.
LIFE AT THE GUEST HOUSE
What is provided?
Each room is equipped with a state-of-the-art hospital bed, side table, lamp, recliner lift chair, and closet or drawer space. In addition, each room has a cable TV, a clock, and a phone. All residents are given ample linens and bath towels, as well as basic toileting items such as toothbrushes and toothpaste. In general, we provide items to assist in the care of the individual residing at the house. For a complete list of our services and amenities, please download our Basic Services sheet.
Are meals provided?
Yes. A full organic menu is provided to residents every day, which includes three homemade meals and snacks. Basic accommodation will be made for residents wishing to store special food items and prepare their own meals. Residents wishing to cook their own meals will need to coordinate with the Food Services Manager.
Is the food strictly vegetarian?
No. A full menu, including meat, is provided.
What are the rooms like?
As a Victorian house built in the 1860’s, each room has its own unique character. There are five resident rooms in the Guest House. All are located on the second floor and vary in size and shape. Four of the rooms are private and one is shared. To see photos of the rooms, click here.
Can I smoke on the premises?
Cigarette smoking is not allowed anywhere inside the facility. There is a smoking area provided on the back deck for residents. However, residents who are utilizing oxygen are restricted from smoking for safety reasons. We are permitted to accept residents who have been prescribed medical marijuana for the purposes of symptom and pain management connected to their illness. Such residents are required to have a physician’s order and are still not permitted to smoke within the facility. In situations where the resident is unable to go outside, alternative methods of administering will be arranged.
What are your visiting hours?
For friends and family: Visiting hours are from 9am to 9pm, 7 days a week. For after-hours or overnight visits, permission is required by Guest House staff. For potential residents: please call 415-913-7682 to schedule a private visit, . For details about our location, including parking and transit, click here.
Can I bring my own furniture and other personal belongings?
Each of the resident rooms at the Guest House is fully furnished and space is provided for personal belongings, such as clothing, towels, toiletries, blankets, and other smaller items. We are not able to accommodate large furniture such as dressers, cabinets, tables, or other such items. Smaller items may be considered on a case-by-case basis. Intake staff will assist in providing resources for donation or selling of personal items if the resident is vacating an apartment or other permanent residence.
Are pets allowed?
In general, this is on a case-by-case basis. Due to the intimate environment of the facility, there are limitations as to the kinds of pets that are allowed. Fish are allowed. Pets such as dogs and cats are allowed on a visiting basis only and should be arranged with facility staff. If in the process of moving to the Guest House a potential resident is concerned about a pet that has been living with them, intake staff can work with that resident to provide a new home for the pet.
Do you perform any rituals around death?
Yes, if we are requested to do so by a resident or a loved one. We can sit meditation at the bedside and extend our loving-kindness and compassion to the person who has died. We can also perform a ritual bathing of the body and sometimes facilitate a memorial service at the bedside. We have memorial services on a quarterly basis to honor and remember all those who have died in our care.
Does Zen Hospice offer spiritual support or guidance to people outside its residential site?
Currently, we offer direct care services only to people in our residential program. However, our Education program, Grief Support Services, and Compassionate Companion Audio Teachings address many of the spiritual issues around illness and dying, and people have found these to be helpful.