How to Choose a Hospice

~by David Casarett, M.D.

Ben Hallman's June 19 HuffPost blog paints a stark and scary picture of today's hospice industry. Hospice, he warns us, is big business. And it seems that business is booming. But his focus on for-profit hospices is not very helpful to patients and families who need hospice.

When people make a decisions about which hospice to enroll in, they don't need scare tactics. They don't need fear mongering about the evils of for-profit hospices. They need to choose a hospice that will deliver the best possible care for whatever time they have left. That is, they need advice. So here's my advice, based on 15 years as a hospice and palliative care physician.

First, ask your doctor for advice. Which hospices deliver the best care? Which have the most skilled staff? Which are the most responsive?

But also ask your doctor if he or she has a financial relationship with that hospice. Some doctors are employed by hospices, and may have a financial incentive to refer. So beware.

Second, pick up the phone and ask questions. Here are a few:
"Do you provide all four levels of hospice care?" (That's routine home care, inpatient care, continuous care at home, and respite care). Medicare-certified hospices are required to provide all four, but many don't.
"Is your hospice certified by The Joint Commission or the Community Health Accreditation Program?" Abbreviated as TJC and CHAP, these are organizations that visit and inspect hospices regularly.
"Are your physicians board-certified in hospice and palliative care?" This is a good indication that a hospice takes its medical care very seriously.
"Do you measure and improve the quality of care that you provide to your patients? How?" Any hospice that doesn't have a quick and clear answer for this question probably isn't serious about patient care.
"How much charity care do you provide?" This may seem like an odd question to ask, but in my experience, it's a pretty good indicator of whether a hospice's heart is in the right place. There's no "right" answer, but beware of a hospice that doesn't offer any.

Third, interview a hospice. That's right, just as you'd interview a job applicant. (Because that hospice is applying for a job to work for you.) Ask the hospice representative to tell you what you can expect. What services will they provide? And when? Ask the representative to explain to you how they'll work around your needs and preferences.

Finally, some general advice. These aren't hard-and-fast rules. But they've served me well in finding hospices for friends and families in cities where I don't know the lay of the land.

Full Article and Source:
How to Choose a Hospice

See Also:
Hospice, Inc.