Gone are the days when hospice programs were few and far between. Communities are now inundated with hospice programs, competing for patient referrals, and often removing patient care from the forefront. Catholic Hospice strongly recommends that patients and caregivers interview hospices prior to signing on with a program. Some things to consider include:
Certification: Is the hospice Medicare certified? Medicare certified programs meet or exceed the federal minimum requirements to be a hospice program. Additionally, Medicare certified programs are evaluated on a regular basis to make sure the requirements are maintained.
Licensure: Many states require hospice programs to be licensed. If you are looking at programs, see if state licensure is required and maintained.
Profit Status: Is the program a registered non-profit agency or a for-profit program? Most non-profit tend to go above and beyond when caring for their patients for the simple reason that they believe in the hospice philosophy and know that it’s not meant to be a “money making business” but a ministry of care. In addition, most non-profit hospice programs are known to follow strict guidelines when looking at appropriateness of patient admissions and utilize the maximum amount of core service visits as needed. Furthermore, most non-profit hospices generally do not have high payrolls to cover marketing costs, do not pay out sales commissions, and do not make payments to shareholders therefore their monies generally filter back into patient care.
Services: What services does the hospice program provide? Medicare certified programs are required to provide all medications, equipment, soft goods, etc. related to the patient’s terminal diagnosis.
Core Service: Does the hospice offer visits from all core team members (nurses, aides, social workers, chaplains, volunteers)? Medicare states that all Medicare certified hospice patients are entitled to visits from ALL core team members, however not all disciplines are always offered. Be sure that your program will provide all disciplines.
Attending Physician: Does the attending physician direct the care while the patients are on hospice? It’s true that the referring physician is typically a part of the hospice team and remains involved in their patient’s plan of care. There are times, however, when the patient prefers that the hospice medical director follow them once they are on the hospice program.
Consumer Information: Does the hospice have written brochures or statements outlining services, eligibility criteria, mission statement, proof of insurance, etc.?
References: Consult the Better Business Bureau to see if the agency has ever had a claim filed. Are they willing to provide references on request?
Patient’s Rights and Responsibilities: Request to see a copy of the patient’s rights and responsibilities. These should be in a written document that is signed by the patient and the hospice.
Plan of Care: Is the care plan developed with the patient and caregivers? Is the care plan updated as the patient’s needs change? Ask if you can review a sample care plan.
Costs: Is the patient/family billed for services? Does the agency offer a sliding fee scale? How does the agency handle billing and payment?
Personnel: Are background checks performed on all employees? Do the employees reside within the service area – important for on-call response time? Does the agency train and supervise personnel? What credentials do team members have? Many programs boast large service areas (for example 13 counties) however they do not have all core staff (nurses, social workers, chaplains, aides, volunteers) residing in all those counties.
Admission: What does the hospice admission process involve? If the hospice imposes upfront conditions that do not feel comfortable, it might be a sign to look elsewhere for care. Does the agency answer your questions about hospice – if your loved one qualifies or if hospice is the best plan of care for your diagnosis?
On-call: Does the hospice have a 24-hour on-call number for patient emergencies? What is the procedure for call back and visits after regular hours? How a hospice responds during your initial contact may be a good indication of the kind of care to expect.
Caregivers: Does the hospice require a caregiver in the patient’s home? What help can the hospice provide to the caregivers? Can the hospice team help to coordinate community resources if necessary? If the patient lives alone, is the hospice team able to help with future plans?
Questions/Complaints: Who are questions and complaints directed to? Is there a procedure in place for resolving issues?
Licensure:
