Palliative Medicine

Here at Hospice of The Piedmont, we offer in-home palliative care for our patients who suffer from severe illnesses to improve their overall well-being, help to manage their symptoms, and ease the discomfort associated with these illnesses.

Yvonne, Palliative Medicine patient with Hospice of the Piedmont

What is Palliative Medicine?

Palliative Medicine is a specialized type of medical care that focuses on improving comfort and quality of life while a patient undergoes treatment for an advanced or serious illness. For our community-based Palliative Medicine program, we organize care for patients with chronic illnesses and treat symptoms of advanced illnesses like pain, nausea, fatigue, shortness of breath, anxiety, and more. You can continue to pursue curative treatment while receiving palliative care services.

Our Palliative Medicine team at Hospice of the Piedmont focuses on delivering patient and family-centered care. We help you navigate your treatment options, make an advance care plan, and connect with community resources that will benefit your quality of life. Our team addresses the physical, emotional, and spiritual needs of patients with advanced illnesses, as well as provides support to their families and loved ones. Our palliative care nurse practitioners communicate and collaborate with your primary care provider to ensure you stay comfortable and feel connected to your existing care team.

To learn more about our in-home palliative care, ask your doctor about arranging a Palliative Medicine consultation, or contact us at Hospice of the Piedmont today.


  • Who can benefit from Palliative Medicine?

    Regardless of a patient’s age or diagnosis, our palliative care services are available to anyone, at any stage of an illness. Patients can receive care from the initial time of diagnosis through treatment and beyond.

    When organizing care for patients with chronic illnesses such as cancer, heart disease, lung disease, kidney disease, Alzheimer’s, ALS, and Parkinson’s, our team at Hospice of the Piedmont focuses on treating symptoms and overcoming additional challenges associated with these advanced illnesses. Patients starting a palliative care program can still pursue curative treatments like chemotherapy, radiation, dialysis, or transfusions from their other healthcare providers.

    Many patients benefit from receiving in-home palliative care because it’s provided in familiar surroundings, giving them a sense of security. Our patients can find comfort in their homes, accompanied by their loved ones, without struggling to adjust to a new place, routine, or new faces while receiving treatment.

    If you’re unsure what services would be best for you or your loved one, our Palliative vs Hospice PDF guide can answer many of your questions regarding the differences between hospice and palliative care services.

  • When should someone be offered Palliative Care?

    Our Palliative Medicine program at Hospice of the Piedmont is best suited for patients who want to continue to live independently and receive palliative care services wherever they call home, instead of in a hospital setting. Whether home is where you’ve lived for decades, a nursing home, an assisted living facility, or a continuous care retirement community, the Hospice of the Piedmont team will bring our patient and family-centered care expertise to wherever you are.

    For patients with acute symptoms that would be better managed in a hospital setting, learn more about our inpatient care sites at the Hospice of the Piedmont Acute Care Center.

  • Starting a Palliative Care program

    If you are interested in starting a palliative care program, ask your doctor about arranging a Palliative Medicine consult, or give us a call at 833-888-0265 or 434-423-0700 and we’ll request the order from your doctor for you. If you opt to participate in the Palliative Medicine program, you’ll receive in-home palliative care visits from a physician or palliative care nurse practitioner.

    Most individuals receive palliative care services on a fluctuating frequency based on need. That could mean one or two times a month at first and then less often until your needs increase. Community-based palliative care can be personalized to fit the individual needs and preferences of the patient and can be provided on a schedule that is convenient to both the patient and all of those involved.

    If you or someone you know is considering palliative care services, read more about why choosing Hospice of the Piedmont is the right move for you.

  • Palliative Medicine Billing and Insurance

    Depending on individual plans, palliative care may be covered by your insurance. Our services are covered by Medicare, Medicaid, and most private insurers.

    We do not use the hospice insurance benefit at all for our Palliative Medicine services. For in-home palliative care visits from our medical team, we bill Medicare Part B and other insurance plans as specialty visits (much like cardiology or oncology are specialist visits). Palliative Medicine does not conflict with Part A billing (home health or skilled care facility) or other provider visits.

    This means when starting a palliative care program, patients can still have insurance coverage for hospitalizations, home health services, provider visits, and rehab in a skilled nursing facility. When receiving palliative care services, you can use insurance for any life-prolonging treatments like chemotherapy, radiation, dialysis, or transfusions, while also accessing extra support from Palliative Medicine consults to address troubling symptoms and discussions about goals of care.

    For patients who have served our country, learn more about Veterans’ Services and coverage here at Hospice of the Piedmont.

Meet our Palliative Medicine Team

Our team consists of our Chief Medical Officer, palliative care nurse practitioners, and a licensed clinical social worker who offer in-home palliative care for patients across our 12-county service region.

This team of medical and administrative professionals works together to provide palliative symptom management and advance care planning for our patients receiving palliative care services. They play a critical role in providing compassionate patient and family-centered care for those with advanced illness, as well as helping to improve the quality of life for them and their loved ones during a challenging time.

Are you passionate about providing care and making a difference in someone’s life? Check out our Careers Page to learn more about joining the Hospice of the Piedmont team.

Chief Medical Officer

Alina Fomovska


Chief Medical Officer

Dr. Alina Fomovska joined Hospice of the Piedmont in January 2023 as a Medical Director, and was promoted to Chief Medical Officer in June 2023. She is a dual-board certified physician specializing in both Emergency Medicine and Hospice and Palliative Medicine. She is committed to promoting excellent end-of-life care across all patient care settings. She has a strong academic experience in medical education, teaching at both Undergraduate and Graduate Medical Education levels. Prior to coming to Hospice of Piedmont, Dr. Fomovska served as an Assistant Professor at the Thomas Jefferson University in Philadelphia. Her academic focus is on the ethics of end-of-life care, and she is Healthcare Ethics Consultant certified by the American Society of Bioethics and Humanities. She is a graduate of the Icahn School of Medicine at Mount Sinai in New York, and completed her residency in Emergency Medicine at the University of California San Francisco. In 2020, she completed a Fellowship in Hospice and Palliative Medicine at the University of Virginia.

Nurse Practitioners

Ashleigh Bergstrom
Ashleigh Bergstrom


Nurse Practitioner

Ashleigh Bergstrom became a part of the Hospice of the Piedmont team in 2015. She earned her bachelor’s degree in Neuroscience from the College of William and Mary, and her Master’s degree in Nursing from the University of Virginia. She worked as a nurse with the University of Virginia Health System in geriatrics and palliative care before returning to UVA to complete her post-Master’s certification as a Family Nurse Practitioner. She is a clinical instructor with the UVA School of Nursing and a board member of Camp Holiday Trails, a camp for children with special health needs.

Sarah Brown
Sarah Brown


Nurse Practitioner

Sarah Brown earned her bachelors in nursing at York College of Pennsylvania and then worked for 10+ years in acute care settings. She then achieved her FNP degree at Marymount University and subsequently worked for 7 years in internal medicine, primarily with geriatrics in long-term-care settings.

Sally Koch


Nurse Practitioner

Earned both her bachelor’s and master’s degrees at the University of Virginia. She previously worked at the UVA Medical Center as an RN in cardiothoracic surgery and in the acute care float pool.

Licensed Clinical Social Worker

Michael Williamson


Licensed Clinical Social Worker

Michael Williamson has worked in hospice and palliative care services for more than 10 years, and in social services in other capacities since 2008. He earned his Licensed Clinical Social Worker licensure in 2017, and has been a Licensed Social Worker since 2012.

Administrative Support Staff

Lara Fisher


Palliative Medicine

Lara Fisher is a compassionate and accomplished social worker with over 16 years of experience in various roles at Hospice of the Piedmont. She joined the organization in 2007 as a bedside social worker and has since held positions such as Intake, Team Leader, Supervisor of Social Work & Chaplains, EMR Facilitator, and now Administrative Director of Palliative Medicine.

Lara’s passion for helping others began when she earned her Master’s in Social Work from the University of Texas at Austin in 2005. Before joining Hospice of the Piedmont, she worked in Family Preservation, served as a house parent for parenting teens, and worked for Child Protective Services.

Lara’s favorite part of her job at HOP is working with her wonderful coworkers toward a common mission. She finds joy in walking alongside patients and families who are focused on what matters most. She feels that being present with those who lead with love and recognize the gifts in their lives is a privilege and a powerful reminder to live in the moment and cherish what is truly important.

Mandy Henkler

Administrative Specialist

Mandy joined HOP in 2018 as a Team Coordinator for the West Team and Hospice House. She assisted the Palliative Medicine team in 2020 and joined full-time in 2022. She earned her degree from the University of Vermont in Community Entrepreneurship and started her career in farming. After a few years of farming, she decided to work as a caregiver for seniors on nights and weekends and ended up working as a full-time caregiver for two years before she joined HOP. In her free time, Mandy likes to walk and bike around town, dabbles in her garden, and spend time with family and friends. Mandy’s favorite part of being on the Palliative Team is the team itself. It is a small group of amazing people supporting one another and our patients with so much heart and care; it is a gift to work with such an amazing team.