Because there are so many hospice agencies in this area, families often have difficulty choosing one and ask, “what should we look for in a good hospice”?
The National Hospice & Palliative Care Organization (NHPCO) has published a Hospice Standards of Practice and a Services Guidelines & Definitions, based on Medicare rules. Before selecting a hospice, ask if the following minimums are met:
1) Staffing – there should be at least 1 RN for every 8-12 patients, with 1 RN on-call per 60-80 patients; 1 social worker per 20-30 patients; 1 chaplain per 40-60 patients; 1 Home Health aide per 12-15 patients; and 1 volunteer coordinator per 60-80 patients. Medicare mandates that every patient should be offered visits from these professionals (the family may refuse specific ones).
2) Bereavement program – pre-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 in crisis situations. 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.