All Hospices Are Not Created Equal

Pulling out my megaphone today! Not all hospices are created equal, here are some questions I ask to discern the best hospice:

(1) how long have they been in business? I prefer a hospice with an established reputation, especially if I’ve heard positive stories from those in my local community.

(2) where is the closest licensed office? The closer you are, the better resourced you will be. If the main office is an hour away, yellow flag! This signals logistical difficulties.

(3) does this hospice have a volunteer program? Even the Medicare system finds it important for community volunteers to support families, which is why they require hospices to offer access to volunteer support. Sadly, it can be less expensive for a hospice to pay the Medicare fine instead of offer volunteers. For me, red flag! This signals profit over people mentality.

(4) how many hours a week will you receive in-person care? Listen to this answer but remember you are being pitched. But in the best case scenario, what should you expect? I want at least 1-hour/week with the RN and 1-hour/week with the CNA for personal care. Ideally, 1-hour/week with the chaplain also. Bare minimum! Remember hospice is being compensated for your care at a rate around $220/per day by the federal government.

(5) what exactly does 24/7 support include? I was shocked to learn that for my family, this meant access to a hotline with a RN on the other side of the line. I recently had a family call their 24/7 support number and it took 2.5 hours for help to arrive and it was not an employee of the hospice but a local nurse who worked at a long-term care facility.

(6) what happens if the caregiver needs respite? I’d start by asking if the hospice had an in-patient residential unit and how often there are beds available to home patients for respite? Would you be eligible for one of those beds? Often, home health hospices only offer a bed in a local nursing home. Is this okay for your person? Also, families often assume they may be able to move to a residential unit for the active dying process. Where I am, this is rarely an option.