Finding a Hospice Program

Finding the hospice program that best meets your needs may take some time. Most areas have more than one hospice option. Your doctor, hospital discharge planner, nurse navigator, or case manager can help you find them. But you, your caregiver, and loved ones will need to decide which hospice is best for you.

Start looking for hospice programs soon after you find out that your cancer can no longer be controlled. That way you will have time to think about your options and be able to help make the decision.  Look for information about quality of care, what services they offer, staff training and expertise, and insurance coverage.

How to find hospice care providers

Local and state resources

Your doctor, navigator, case manager, social worker, or hospital discharge planner can often help you find hospices in your area. Hospice care providers also are listed in the phone book.

There are some local and state resources that might be able to help you find hospices in your area.

• Your local Agency on Aging

• Your state department of health

National resources

The National Alliance for Care at Home or medicare.gov can help you find hospice services near you.

Check your insurance coverage

If you have insurance through Medicare, Medicaid or the Veteran's Administration, talk with your cancer care team about how you can get hospice benefits when they are needed.

If you have a private insurance plan, check with your insurer to determine if you have hospice coverage. If you do, find out what options you have, including any preferred hospice providers. Doing this ahead of time can save some stress later.

What to look for in a hospice program

There are many things to look at in choosing the best hospice to meet your needs. First, you’ll want to talk with your cancer care team and decide what services you’ll need. Then you can look for hospice programs that offer those services. Here are some of the things you might ask about a home care agency.

Is the hospice provider accredited by a nationally recognized group?

Check to see if an agency is accredited (certified and licensed) by a nationally recognized group, such as

• The Joint Commission
• Accreditation Commission for Health Care (ACHC)
• Community Health Accreditation Partner (CHAP)

Is the hospice provider approved and certified for Medicare?

Medicare-certified programs must meet set requirements for patient care and management. Many non-Medicare health plans follow Medicare's guidance on approval and certification. Payment for hospice services may depend on the program's approval or certification so check to be sure.

Is the hospice provider licensed in your state?

You can check with your state health department to find out if your state requires a hospice provider or program to be licensed.

Will health care professionals recommend the program?

Consider finding out how many years the hospice program has been serving your community. Ask them to give you references from professionals – such as hospital staff or social workers – who have sent other people to them. Also, check with the Better Business Bureau, your local Consumer Bureau, or the State Attorneys General’s office.

Is the agency a good fit for your needs?

Ask for information

Ask if the hospice has written information about the services they offer, who can be in their hospice, costs and how payments are made, what staff they have, and malpractice and liability insurance. Ask them to send you any brochures or other information about their services.

What services are offered?

Most hospices offer similar services. Ask if you think you would need more specific services, such as those provided by physical therapists, pharmacists, dietitians, or family counselors.  If needed, find out if the hospice provides medical equipment or other items that might improve your quality of life.

Is a primary caregiver required?

Ask if the hospice requires you to have a primary caregiver and if someone needs to be with you all the time. Also ask what the primary caregiver will be expected to do. You may want to ask if the hospice can fill in to help with care around job schedules, travel plans, or other responsibilities. Or, if you live alone, ask what other options the hospice suggests.

How is the first evaluation done?

Usually a nurse, social worker, or case manager comes to give you information about hospice and see what type of services you might need. Ask where this will be done, what the evaluation involves, and who should be there during the visit. You might also want to ask if your family or cancer care team will be involved in planning your care.

How are care plans created?

Hospice providers should offer a care plan for each person who starts hospice. Ask how the plan is developed and if you and your family will be able to give input. The care plan should list specific duties, work hours/days, and the name and telephone number of the person in charge of your care. The care plan should also be updated as your needs change. You can ask to see an example of a care plan.

Who will provide your care?

You might want to ask about references for home care staff, and if the agency trains, supervises, and monitors its staff, caregivers, and volunteers. Ask how often the agency sends a supervisor to the patient’s home to review the care being given to the patient. Ask if the caregivers are licensed and bonded. Ask who takes questions or complaints, and how issues are resolved.

How is payment handled?

Find out how the hospice handles payment and billing. Read any agreement before signing it and be sure to keep a copy. Check with your health insurance provider to find out if there are any deductibles and co-pays. For example, certain medicines and respite care may require a co-pay. Ask about resources the agency provides to help you find financial assistance if it’s needed.

Communication with the hospice provider

The agency should have a 24-hour telephone number you can call any time you have questions or problems. Ask about the procedure for calling for problems, and for making and resolving concerns or complaints. How a hospice responds to your first call to ask about services may be a good sign of the kind of care to expect.

Emergency planning

Ask if the agency has an emergency plan in case of bad weather, a power failure, or a natural disaster.  You can ask to see a copy of the plan. In an emergency, you need to know if the hospice provider can still deliver services to your home.

Limits on treatment

During your first visit, be sure to talk about the treatments you are currently getting. Talk to the hospice provider if you would like to continue any of them.

Some hospices (and insurance plans) will not cover things like dialysis, intravenous feedings, blood transfusions, and certain medicines. Some hospices do allow certain medical treatments to continue, but this will likely depend on your insurance coverage as well. Find out how the hospice would handle your current treatments before committing to their services.

You’ll also want to find out what the hospice would do if you developed new health problems that would be curable, such as a urinary tract infection or pneumonia. You may be more comfortable if they’re able to treat these types of problems.

Inpatient or respite care

Even if you plan to get hospice care at home, you might need inpatient or respite care at some point. You might want to ask questions about inpatient and respite care before deciding on a hospice provider.

●    Can hospital or respite care be provided?

●    What are the requirements for an inpatient admission?

●    How long can a patient stay in a hospital before it affects their hospice benefits?

●    What happens if the patient no longer needs inpatient care but can’t go home?

●    Which hospitals or nursing homes contract with the hospice for inpatient care?

●    What kind of follow-up does the hospice provide for inpatients?

●    Does the hospice provide nursing, social work, and aide care during respite care or an inpatient stay?

Changing hospice provider

If you don’t like the hospice service you choose, you can change providers.

Check with your first insurance company to be sure that you can make this change without interrupting payments or services. They can tell you how to stop care with your first hospice agency and sign up with another one.