I’ve been told there are many hospices in this region. How do we know which one is best?
With so many hospice agencies, families are often referred to one based on contacts that friends or relatives have, or because their doctor tells them they have to have a particular one.
The National Hospice & Palliative Care Organization (NHPCO) has published a Hospice Standards of Practice and a Services Guidelines & Definitions, based on Medicare rules. If you are concerned about the quality of care you might receive, ask the agency offering you service if they meet the following minimums:
1) Staffing – there should be at least 1 RN for every 12 patients, with 1 RN on-call for no more than 80 patients; 1 social worker per 30 patients; 1 chaplain per 60 patients; 1 Home Health aide per 15 patients; and 1 volunteer coordinator per 80 patients. Medicare mandates that every patient should be offered visits from these professionals (although the family can refuse some of these, the RN must visit at least weekly).
2) Bereavement program – post-death services and support for 13 months after death.
3) Access to all levels of care and in all settings (including hospitals) without regard to reasonable cost; patients cannot be discharged from hospice care because of expenses incurred.
4) Continuous care provided during crisis situations (as in uncontrolled pain or shortness of breath). Patients always have the right to choose, even if a physician or institution says they must pick a specific agency; it is a violation of Medicare’s condition of participation to deny choice and violators risk both penalties and losing their Medicare contract.