Hospice: How to Find & Assess

February 11th, 2008 by Gilbert Guide

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Gilbert Guide provides listings of hospices in your area, along with advice for finding the hospice that will best suit your individual needs. Hospice care can be provided at home or in a facility setting. Once you've narrowed your choices down, it's important that you meet potential hospice providers in person to determine whether they're a good fit for you.

Finding a Hospice

Most hospice agencies are licensed by the state and many are certified by Medicare. The National Hospice and Palliative Care Organization (NHPCO) maintains a database of hospice listings throughout the country.

Some people consider Medicare certification to be the basic criteria for assessing an agency's quality of care. However, non-certified hospices can also provide an exceptionally high quality of care. What's most important is that the certification means Medicare Part A will pay for hospice care. Read more detailed information on paying for hospice care.

Assessing a Hospice

To assess a hospice's quality of care you'll need to consider multiple factors. Caregivers are a primary consideration in the day-to-day care; however, quality of care is also dependent on management, supervision and protocols. You'll also need to consider how affordable any out-of-pocket expenses will be.

Questions to Ask

It's best to phone an agency before planning a visit, so you can spend your time visiting only those caregivers who you think will meet your needs. The following questions should be able to help you get a feel for how the agency runs.

Are you Medicare certified?
Is your medical director an MD? (This isn't required by law, but it is a quality indicator.)
Are supervisors on call 24 hours a day? (In an emergency, you'll need to be able to contact someone at the agency.)
How long it will take for someone to reach my residence in an emergency?
How often caregivers are checked in on by supervisors? (Weekly checks and as needed are best.)
How do supervisors check in with caregivers-over the phone, via progress notes or in person?
How frequently does a nurse visit each patient? (The best agencies usually have a twice-weekly visiting schedule, with the same nurse visiting each time.)
How often do you hold patient meetings? Is a doctor in attendance for these meetings? (During a patient meeting, the entire staff gathers to discuss each patient. Weekly is good; some agencies hold twice-weekly meetings.)
What protocols exist in the event that my loved one's health status changes?
Are RNs available by phone only or also for home visits?
Is RN availability dependent upon whether the status change occurs outside of business hours?
What is the average caseload of each manager? (More than 15 cases per manager means that there is a potential that the patients are not receiving enough individualized attention.)
If all services will not be paid by in full by Medicare, when will you inform me of how much I will pay out of pocket? (The hospice should inform you exactly how much you will be paying after assessing the patient's case.)

Meeting with Potential Caregivers

Only you can decide whether a certain caregiver will be a good fit for your loved one. Think about your loved one's personality and how he or she might interact with each caregiver you meet. Another thing to keep in mind is that the hospice agency may send over different caregivers based on availability, so keep the lines of communication open with the hospice agency, especially if you have a preference for a particular caregiver.

Posted in: Finding Hospice, Hospice & Palliative Care, Hospice Care