While all Medicare certified hospices offer the same basic services, there may be differences among hospice providers that are important to you. We will guide you on how to get information about hospices and what questions to ask potential providers to help you choose the best hospice for your needs.
Finding a Hospice
Patients and families opting for hospice often receive a referral to a specific hospice from their physician. If this has happened, you should still ask questions of the provider to make sure the hospice fits your needs.
If time and conditions permit, it may make sense to explore options available in your geographic area. Certain states have more stringent requirements for certifying hospices than others. Some areas have experienced an explosive growth of hospice providers, beyond what the population can support. You can use:
- Medicare.gov’s Care Compare website. Care Compare is a very useful website sponsored by the Centers for Medicare and Medicaid. You can search in your geographic area to review and compare information such as non-profit or for-profit status, length of time in business, number of patients served, types of patients served, and where patients are served, among others. The data also include quality measures and family feedback.
- The “Find a Provider” tool on the National Alliance for Care at Home website.
- The Hospice Directory on the Hospice Foundation website.
Other useful sources of information that may help you create a short list of possible providers are:
- Professional opinions from individuals familiar with hospice services such as your clinicians, professional caregivers, geriatric care managers, or end-of-life doulas.
- The opinions of your inner circle, friends, neighbors, and acquaintances that have had experiences with hospices in your area.
Learn What Services a Hospice Offers
If you are considering using hospice services, familiarize yourself with the basic services of hospice.
Hospices that participate with Medicare offer the same basic services in accordance with Medicare regulations (Source: Medicare.gov). These regulations outline what a hospice must minimally provide to patients enrolled in hospice under Medicare. The Medicare rules have been adopted as an industry standard; the rules apply to all patients under hospice care regardless of insurance coverage.
There may be differences among hospices that are important to you and your inner circle. These differences can include:
- offering after-hours services,
- providing ongoing care for certain conditions,
- being faith-based,
- having a robust volunteer program,
- or having certification by a national organization.
Before contacting a hospice, write down any non-Medicare required services you are interested in so that you are sure to ask about them.
If you are specifically searching for a Jewish hospice, consult the National Institute for Jewish Hospice. There is no national organization for Catholic hospices, so you should consult with your parish or regional Catholic healthcare system.
Questions to Ask to Help You Choose a Hospice
We have assembled a list of questions to ask when you are interviewing prospective hospices. They include:
- What services are provided?
- Does this hospice participate in Medicare?
- What kind of support is available to the family/inner circle/caregiver?
- What roles do my personal physician and the hospice physician play?
- What does the hospice volunteer do?
- How does hospice work to keep the patient comfortable?
- How are services provided after hours?
- How and where does hospice provide short-term inpatient care?
- With which nursing homes or long-term care facilities does the hospice work?
- How long does it typically take the hospice to enroll someone once the request for services is made?
- Can the patient receive therapeutic, but not curative, care for certain conditions, such as radiation to treat pain?
- Has the hospice been accredited by the Joint Commission or the Community Health Accreditation Program? If so, the hospice should be able to provide documentation.
When speaking with people from a hospice, trust your perceptions—if they are trying too hard to ‘sell’ you, beware.
The Alliance has created a worksheet to help you select the best hospice for your needs. You can download this form at NHPCO.org and write notes when you contact a local hospice.
Working with Your Selected Provider
Once you have chosen a hospice provider, you can:
- Call your chosen hospice and request services. The hospice staff will then contact the patient’s physician to determine if a referral to hospice is appropriate. OR
- Ask the patient’s physician to make a referral to the chosen hospice.
It is never too early to know your options and learn more about hospice care. Learn more about the differences between palliative and hospice care to inform your conversations with providers.
