Frequently Asked Questions

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Frequently Asked Questions2020-07-03T12:49:05-04:00

General FAQs

Is a referral needed from my doctor?2020-06-26T19:32:02-04:00

Insurance carriers (including Medicare) require that we receive a doctor’s orders prior to providing services for clinical services and Hospice, however referrals are not needed for Meals on Wheels and other community services.

Please contact Care Coordination for more information.

To speak with one of our Care Coordination nurses:

call 603-352-2253 or 800-541-4145 or email

You’ll speak in confidence with a member of our staff to discuss your situation and receive completely free, no-obligation information regarding our services and how we can help.

What payment options are available?2020-06-22T13:07:31-04:00

Home Healthcare, Hospice and Community Services is a LOCAL, not-for-profit organization. Many services are funded by Medicare, Medicaid, private insurance plans, donations, and grants. No one is denied the care necessary for their health and safety solely on the basis of ability to pay.

Home Healthcare, Hospice and Community Services is Medicare certified and licensed by the State of New Hampshire as a home care provider.

HCS can accept bill payments online. Please click here to access the payment website.

How do I ask for services for myself or a loved one?2020-06-26T18:51:52-04:00

Determining what your family member, friend or neighbor needs and how to pay for it can be a difficult undertaking. Our Care Coordination staff can answer your questions and discuss services that would be helpful.

To speak with one of our Care Coordination nurses:

call 603-352-2253 or 800-541-4145 or email

Care Coordination is available Monday through Friday from 8:00 am to 5:30 pm and weekends and holidays from 8:00 am to 4:00 pm.

You can also stop by our office in Keene for Walk-in Wednesdays, on the first Wednesday of every month, from 2:00-4:00pm. You’ll meet in confidence with a member of our staff to discuss your situation and receive completely free, no-obligation information regarding our services and how we can help.

Individual Program FAQs

Are there additional benefits of physical and occupational therapies?2020-06-21T07:49:18-04:00

Yes, there are several additional benefits including:

  • Help with obtaining necessary medical and/or assistive devices
  • Support and education for family members who are helping you
  • Bed mobility and transfer training
Are there other services that can aid me in my recovery?2020-06-21T07:56:16-04:00

Yes. There are several other options that can be of further help, including:

  • Skilled nursing when ordered
  • Coumadin blood level monitoring
  • Staple/suture removal
  • Wound assessment
  • Dressing changes
  • Support services
Will Medicare or my insurance cover these services?2020-06-25T17:24:29-04:00

Physical and Occupational Therapy services are covered by most insurances and Medicare when ordered by a physician who has evaluated your condition within the last sixty days.

In order to be covered by Medicare, you must also be homebound, which is defined as not able to leave your home without “considerable and taxing effort.”

How can I get started?2020-06-25T17:27:47-04:00

Ask your doctor to consider a referral to Home Healthcare, Hospice & Community Services if you can benefit from services due to:

  • Joint replacement surgery, such as hip or knee replacement
  • Stroke
  • Heart failure or heart attack
  • A noticeable decline in functioning, such as difficulty walking, loss of balance, or falls
Is there more I can do when I finish my rehabilitation?2020-06-26T18:03:37-04:00

There sure is! Age In Motion (AIM), an exercise program for older adults, is available in many communities on a donation basis.

Lead by trained instructors, AIM increases strength, flexibility, and bone density.

Visit the Age In Motion (AIM) page for a complete schedule of classes and information on how to join.

When does the Friendly Bus run?2020-06-25T17:29:38-04:00

The Friendly Bus operates Monday through Friday from 8am to 4pm, excluding major holidays.

How can I schedule a ride?2020-06-25T17:30:20-04:00

Scheduling a ride is as easy as dialing 603-352-8494. The dispatch office is open Monday through Friday from 8am to 4:30pm. Rides must be reserved one day in advance. Rides on Mondays must be scheduled on Friday.

In order to accommodate everyone, the dispatcher may ask you to board a little earlier in order to share a ride with someone else. Use the extra time to get to know someone else who is riding, read a book, make a grocery list, or enjoy the sites around Keene!

Please let the dispatcher know if you use a mobility device, such as a walker, cane, or have oxygen so that we can better assist you.

Are the buses accessible?2020-06-25T17:31:23-04:00

Yes! The Friendly Buses are equipped with lifts and other assistive devices for rider convenience when boarding and riding.

All drivers have CDL licenses with passenger endorsement, and have passenger assistance training to ensure a safe and comfortable trip.

Can I get help with shopping on the Friendly Bus?2020-06-25T17:32:49-04:00

Friendly Bus drivers are happy to assist you onto the bus with your packages. Drivers are also allowed to make one trip to your door to bring packages to a first floor door of your home, but cannot enter the house.

Riders may also bring a shopping cart aboard the bus to help with packages.

A regular trip is scheduled to Market Basket in Swanzey on the second and fourth Tuesdays of every month.

Call the dispatch office at 603-352-8494 for details.

What is the fare?2020-06-25T17:33:23-04:00

A donation of $1 for a one way trip is encouraged.

No one is denied service for inability to contribute.

How do I sign up as a new rider on the Friendly Bus?2020-06-25T17:33:58-04:00

New riders are welcome! Sign up as a new rider by calling the dispatch office and giving your name, address, telephone number and directions to your home.

If you use assistive or mobility devices, please let the dispatcher know so that we can schedule the right amount of time for your pick up.

Your information is kept confidential, but having it on file will help our dispatchers respond to your ride request quickly.

Where does the Para Express operate?2020-06-25T17:51:15-04:00

The Para Express will pick up or drop off customers within 3/4 mile of the City Express fixed route service.

When does the Para Express operate?2020-06-25T17:50:28-04:00

The Para Express operates the same hours as City Express buses.

Red & Black Routes:
Monday through Friday from 8 a.m. – 5 p.m.

KSC Campus Shuttle (when in session):
Monday through Friday from 7:30 a.m. – 7:30 p.m.

How do I become a Para Express rider?2020-06-25T17:42:34-04:00

The Para Express is public transportation for people whose disability prevents them from using the City Express fixed route service. If you are a person with a disability, you or your care provider may request an application.

  • Call 352-2253 to request an application. Information is available in Braille or large print format.
  • Mail the application to:
    Transportation Department
    Home Healthcare, Hospice and Community Services
    P.O. Box 564
    Keene, NH 03431

Your application will be evaluated by transportation department staff.

  • A follow up may be scheduled with a healthcare professional from HCS to verify your transit disability.
  • An eligibility determination will be made within 21 working days after the application and healthcare verification are received.
  • You will receive a letter from the City Express with your eligibility determination. If you are eligible, you will be certified for a specific period of time, usually 6 months up to 2 years. Eligibility may also be granted on a seasonal or trip by trip basis. This will be outlined in your eligibility letter. You will need to reapply prior to your expiration date for re-certification. The Para Express will send you a new application prior to your expiration date as a reminder to avoid any lapse in service.
  • If you are not eligible, you may appeal the determination. The procedures for appeal will be outlined in the determination letter.
How do I schedule a trip?2020-06-25T17:44:16-04:00

Trip Request Line – 603-352-8494

Be sure to tell the dispatcher:

✓ The date and time of your pick up
✓ Where you would like to be picked up
✓ Where you are going
✓ What time you need to be at your destination
✓ If you will need a return ride, and when you will need that ride

Don’t forget to leave your telephone number so that we can reach you!

If you need to cancel you must call us!

When can trip requests be made?2020-06-25T17:45:01-04:00

Monday through Friday from 8 a.m. to 5 p.m.
Sunday from 8 a.m. to 5 p.m.

Next day reservations must be made by 5 p.m.

Reservations made on Sunday will be taken by voice mail; the dispatcher will call back Monday morning with your ride time.

Trip requests may be made up to 14 calendar days before your intended trip.

What is the fare?2020-06-25T17:45:38-04:00

The fare to ride the Para Express is $2.00 per one way trip. Personal Care Attendants (PCA’s) ride free. Companions may ride with you as long as space is available and they have the same pick up point and destination. The fare for companions is $2.00 per one way trip.

What happens if I don’t show up on time?2020-06-25T17:46:11-04:00

When the bus arrives, the driver will wait for you to board for 5 minutes, then will go on. Riders who are “no shows” three times in a 60-day period may be suspended from using the service for 30 days.

Canceling a ride less than one hour before the designated pick up time is also considered a “no show.” We notify riders, in writing, if there is a need to initiate a suspension process, including the opportunity to appeal the suspension.

If I am visiting the area do I still need to complete an application?2020-06-25T17:46:53-04:00

The City Express welcomes visitors who have certification from another transit agency. Your eligibility will be honored for 21 days from your first ride. We strongly recommend that those who are planning to stay past the 21 day visitor period begin the application process immediately.

What are the Rules of the Road for riding on the Para Express?2020-06-25T17:47:46-04:00
  1. Riders must be outside and approaching the bus at their designate pick up time. Your pick up time can be up to one hour before your requested time.
  2. All riders must remain seated while the bus is moving.
  3. Animals are prohibited except for service animals; please let the dispatcher know if you have a service animal.
  4. Smoking, eating and drinking is prohibited.
  5. Riders cannot bring packages or luggage on the bus that they cannot manage themselves.

Bus drivers can help you on and off the bus at a stop. They cannot leave the bus to help you into or out of buildings.

How do I make a ride reservation?2020-06-25T17:54:30-04:00

Call the HCS Transportation Office at 603-352-8494 to schedule your ride. The office is open from 8:00am to 4:30pm, Monday through Friday. HCS Medical Transportation is available on Wednesdays.

  • You must call to reserve your seat by 2:00pm on Tuesday.
  • Trips may be reserved two weeks in advance. Riders will be called with a pick-up time on Tuesday.
  • If you need to cancel, please let us know as soon as possible.
  • Please remember that the bus is scheduled to depart for Keene by 2:30pm. Please make your appointments so that you will be ready to return with us.

Reservation Line

HCS Transportation Office 603-352-8494

TTY use 711

Where can I get on the bus?2020-06-26T17:06:15-04:00

Medical Transportation departs from the HCS office at 312 Marlboro Street in Keene. If necessary, riders can be picked up at their home in Keene. Riders from outlying communities are requested to meet the bus at the HCS office. Ample parking is available if riders choose to park and ride. Pick-ups can also be made along the route.

When is transportation available?2020-06-25T18:00:38-04:00

Medical transportation is available every Wednesday. Medical transportation is a shared ride service and departure times may vary to coincide with the first appointment.

For everyone’s convenience, please make appointments between 9:00am and 1:00pm.

  • 8:00am Prompt departure from HCS at 312 Marlboro Street in Keene
  • 10:00am *Arrival at VA Medical Center in White River Junction
  • 10:30am *Arrival at Dartmouth—Hitchcock Medical Center in Lebanon
  • 2:30pm Prompt departure from Dartmouth—Hitchcock for return trip
  • 2:45pm Prompt departure from VA Medical Center
  • 4:30pm *Arrival at 312 Marlboro Street in Keene

If you are not able to return at 2:30pm, please make arrangements for alternative transportation to your home.

*Arrival times are approximate.

Is the vehicle accessible?2020-06-25T18:01:38-04:00

The vehicle is fully accessible for up to 11 passengers. Wheelchairs can be accommodated depending on their size. The ambulatory seating available varies according to the number of mobility devices on the trip.

Is there a charge for the trip?2020-06-25T18:02:10-04:00

A donation of $20.00 is suggested for the round trip to help defray the cost. No one will be refused medical transportation due to inability to donate.

Is medical transportation available in Keene?2020-06-26T17:07:27-04:00

Transportation is also available Monday through Friday to

  • The VA Outpatient Clinic at 640 Marlboro Street in Keene
  • To all Dartmouth-Hitchcock medical facilities in Keene.

Call HCS Transportation at 603-352-8494 for route and schedule information for the Friendly Bus for seniors (60+) and the City Express, Keene’s Bus for Everyone.

Who can ride?2020-06-25T18:04:08-04:00

Transportation is available to those needing rides to medical appointments. Priority is given to those over age 60, veterans and individuals with disabilities.

Rides for priority groups will be scheduled on a first come, first serve basis. Others with a medical appointment may ride on a space available basis.

Children under 18 must have a parent or legal guardian accompanying them. Family members or friends may accompany to assist.

How can I make an appointment?2020-06-28T17:14:18-04:00

Call Home Healthcare, Hospice & Community Services at 603-352-2253.

Appointments for all foot clinic sites are made through the main office.

Is there a fee?2020-06-28T17:13:31-04:00

There is a fee of $25 for this service. Insurance does not cover this service.

Do I need a doctor’s referral?2020-06-28T17:12:59-04:00

If you have diabetes, problems with your circulation or neuropathy, you will need a referral from your doctor. Otherwise, a referral is not needed.

What is hospice?2020-06-28T17:09:41-04:00

Hospice focuses on living life to the fullest while experiencing a life-limiting illness. Hospice is a holistic approach to end of life care, focusing on quality of life and offering physical, emotional and spiritual comfort.

When is the right time to call hospice?2020-06-28T17:11:01-04:00

Although end of life care may be difficult to discuss, it is best for family members to share their wishes long before it becomes a concern. This can greatly reduce stress when the time for hospice is needed. By having discussions in advance, people are not forced into uncomfortable situations. Instead, individuals can make educated decisions that include the advice and input of family members and loved ones. Hospice at HCS will meet with individuals and families to explain hospice care. No physician order is needed, and informational visits are made at no charge.

Who pays for hospice care?2020-06-28T17:11:58-04:00

Medicare covers 100% of hospice services. Hospice can also accept Medicaid, Veterans administration benefits and private insurances.

Where do hospice patients receive services?2020-06-28T17:15:12-04:00

Hospice care is provided wherever people call home — their residence, assisted living facility or nursing home.

Is hospice just for cancer patients?2020-06-28T17:16:30-04:00

Not anymore. When hospice began in the mid 1970s, most hospice patients had cancer. Today, while many hospice patients still have cancer, the  majority have other life-limiting illnesses such as end stage heart, lung, or kidney disease, or Alzheimer’s dementia.

Who provides hospice care?2020-06-28T17:18:29-04:00

Hospice patients receive care from registered nurses who specialize in hospice care, home health aides, social workers, spiritual care counselors, and bereavement staff. Patients keep their own physicians, but we do have a hospice medical director who is Board Certified in Hospice and Palliative Care overseeing care.

This “interdisciplinary team” coordinates the care and support for the patient and family. In addition to the professional staff,  volunteers are available to help patients and families, providing respite, sitting with patients, taking them out for a ride, and generally being a “good neighbor.”

Does Hospice mean giving up? Does choosing hospice mean giving up all medical treatment?2020-06-28T17:20:45-04:00

Hospice is medical care with the goal of comfort and dignity for someone whose life is drawing to a close. It is, in fact, the “something more” for someone who has been told nothing more can be done for them. Hospice provides high-quality pain management and symptom control with the goal of making people as comfortable as possible.

What is Palliative Care?2020-06-28T20:32:57-04:00

Palliative Care is an approach to care that focuses on relief from symptoms, pain, and stressors – whatever the stage of the illness. Palliative Care Support at HCS is an extra layer of support that can be offered to our patients while receiving home-based visiting nurse or  rehabilitative services. As this layer of support is provided within skilled home care services, it is short term in nature. Palliative Care Support at HCS is a person-centered, Social Work-led service that prioritizes your needs, concerns, and wishes for your best quality of life.

  • Support includes:
    Palliative Care Conversations in which we get to know you and your goals
  • Evaluation of pain and discomfort
  • Support navigating the healthcare system, understanding options and resources, and coping with your situation
  • Guidance in weighing and making choices – both practical and complex
  • Assistance around any area of stress impacting your quality of life
Do I qualify for Palliative Care Support?2020-06-28T20:35:29-04:00

Palliative Care Support at HCS is available to patients receiving HCS home-based visiting nurse or rehabilitation services. Palliative Care at HCS requires a physician order and may be covered under insurance. Patients without insurance may be eligible for a grant-funded Palliative Care Social Work visit.

For more information, please call Care Coordination at HCS at 603-352-2253.

What is the Palliative Care conversation about?2020-06-28T20:38:16-04:00
  • Understanding and exploring ways to best manage unwanted symptoms, pain, and discomfort and optimize quality of life
  • Finding resources to help with the practicalities and necessities of daily living
  • Emotional support when you are at a crossroads and need to make difficult decisions
  • Help with Advance Care Planning (ACP), including advance healthcare directives and Provider Orders for Life Sustaining Treatment (POLST)

Palliative Care Social Workers are trained ACP facilitators and will help you make sure your wishes are communicated, documented, and that
decision making burdens are eased for you and your family.

When should you or a loved one have a Palliative Care Conversation?2020-06-28T20:39:57-04:00
  • When faced with a new or ongoing chronic progressive illness such as cancer, heart, lung or kidney disease.
  • When struggling with treatments and their side effects.
  • If you or a loved one are simply having trouble understanding your condition and options, and are uncertain about the path ahead.
Who is the Palliative Care Support team at HCS?2020-06-28T20:41:17-04:00

Master Level Social Workers experienced in Palliative Care

Nurses, Rehab Therapists, and LNAs working with a Palliative Care approach

What is Behavioral Health Home Care?2020-06-29T15:11:50-04:00

The Behavioral Health Home Care program assists patients and families who are broken and wounded by mental illness to move toward wholeness.

The Behavioral Health Care program is a holistic approach to care, using standardized assessment tools that allow for a collaborative  approach between you as the physician and Home Healthcare, Hospice & Community Services as the home care provider. The program  increases compliance with medication and medical follow-up, and decreases hospitalizations as well as emergency calls to physicians.

Who should be referred for behavioral health services?2020-06-29T15:19:14-04:00

When making a referral, please note that the client must be homebound or psychiatrically homebound. If a client is unable to consistently and independently access psychiatric follow-up, he or she may be considered homebound. The following behaviors and conditions demonstrate that the patient may be psychiatrically homebound:

  • Impaired reality
  • Disoriented
  • Confused
  • Impaired judgment
  • Agoraphobic
  • Depressed
  • Anxious
  • Uses assistive device (cane, walker)
  • Limited endurance related to medical diagnosis
  • Leaving home requires taxing effort

Admission Criteria:

  • Client must have a primary psychiatric diagnosis,or a medical and psychiatric diagnosis
  • Client must be under care of a physician
  • Client must require the skills of a behavioral health nurse

Who should be referred for services?

  • Newly diagnosed adults with a psychiatric diagnosis
  • Clients on new psychotropic medication
  • Clients who have difficulty connecting to traditional mental health services
  • Clients who have issues with medication compliance
  • Clients who have difficulty leaving their home
  • Clients who are frequently hospitalized with psychiatric diagnosis
  • Clients with depression, anxiety disorders, schizophrenia, bipolar disorders, dementia or Alzheimer’s disease
Who should not be referred for behavioral health home care?2020-06-29T15:17:15-04:00
  • Clients whose behavior poses a risk to self or others
  • Clients who are actively using drugs/alcohol and are not engaged in substance abuse treatment
  • Clients who are actively suicidal
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