How to Choose a Hospice Provider

How to Choose a Hospice Provider

When you are thinking about how to choose a hospice provider, there are some simple things that can help.

First, it is common to receive a physician’s referral to a specific hospice provider for patients and families choosing hospice care. You may take that referral, or you may consider other hospice providers serving in your area.

You may feel lost, navigating through a situation that you’ve never been in.  That’s common.  This can feel like a big decision, so we put together some ideas that might help you understand this better.  Most importantly, we are also available at any time you might have questions, please don’t hesitate to call.

Most Hospices Offer Similar Services

Most hospices participate with Medicare.  They provide the same services in accordance with Medicare regulations. These rules layout what a hospice must provide to patients enrolled in hospice.  They have been adopted as the industry standard for hospice care. These rules apply to the care of all patients under hospice care, regardless of their insurance coverage.

However, there may still be a few differences among hospice providers. Some of these things may make one hospice more appealing than another. It’s important to make a choice based on the needs of your family, preferences, and insurance.

Lastly, if the patient is enrolled in Medicare, it is very important to receive care from a Medicare-certified provider. Some private insurance companies and Medicare Advantage plans may require a “preferred provider”.  A preferred provider is a hospice that the insurance company has negotiated a better rate with.

Compare Hospice Providers

When comparing hospice providers, you will want to consider the following:

Seek a professional opinion. Ask people who have professional experience working with hospice providers.  For example, ask clinicians, caregivers at nursing homes, geriatric care managers, or end-of-life doulas about their experience with a hospice provider.  Their opinions may be valuable.

Talk to your friends, family, and neighbors who have used hospice services.  Get their opinions about their experience with a provider.  Having an experience with a hospice provider can help make that choice.

Accreditation

You might look to see if the hospice is accredited by the Joint Commission or by the Community Health Accreditation Program. This accreditation is not required.  It does not mean a hospice is substandard if they do not have it.  However, it indicates that a third party has determined the hospice meets or exceeds an established standard of care.

Search the California hospice association’s website. The California Hospice and Palliative Care Association website has a lot of information that may help you learn more about hospice.  Ultimately, it may help you choose a hospice provider.

Finally, it is common practice for potential hospice providers to send a representative to meet with the patient and the family/loved one/main caregiver to discuss eligibility for hospice care.  They will go over the services provided and answer any questions.

Questions to Ask

When you are choosing your hospice care, it is important to ask the right questions.  When meet with a representative, you may use some of these questions to guide your conversation.  These questions may give you the answers that will help you make your choice.

Before you start asking questions, it’s a good idea to have a friend or family member with you to act as an advocate and to also take notes.

• What is expected of the family caregiver?
• Will the hospice provide training to family caregivers?
• How often will a hospice team member visit the patient, and how long will most visits last?
• When the hospice orders medication, where do we get that?   Is there an option for the medication to be delivered by the hospice?
• What is the typical response time to reach someone at the hospice during normal business hours?
• What is the typical response time to reach someone at the hospice after normal business hours, weekends and/or holidays?

Additional Questions

• Will the hospice send a registered nurse, nurse practitioner, or physician to the home if the patient’s symptoms are not being managed? How long will it take the nurse/doctor to arrive?
• When will a plan of care be developed by the hospice?  Will that plan be shared with family/caregivers
• What steps does the hospice take when the patient’s symptoms cannot be managed at home?
• If there is a need for inpatient care, how will that be addressed by the hospice? Where will that care be provided?
• Are there any services, medications or equipment that the hospice does not provide?
• What are the out-of-pocket expenses we should anticipate?
• Does the hospice provide respite care to give family caregivers a break?  How does the hospice arrange that?  Where will the patient go during respite care?
• Does your hospice provide volunteers?  What help do your hospice volunteers provide? How can that request for volunteer help be made?
• If a hospice team member is not present during the time of death, will the hospice provide guidance and support to the family?  What will that look like?
• Is there bereavement support offered by the hospice?
• If we are especially unhappy or dissatisfied with some aspect of care the hospice is providing, who should be contacted and how?  How is that typically managed?

How to Choose a Hospice Provider

This list of questions may be incomplete.  However it may help you think about more specific questions for your situation.  These questions should serve as a way to guide the conversation and get you answers on how to choose a hospice provider.

When you have made that choice, or are in the process of choosing, the next step of the process may be to learn how to prepare for hospice care.