Checklist for Evaluating Hospice Programs
Overview
Once you make the decision to seek hospice care, make your search easier by using this checklist to find out about different programs. Add to it as you think of items that are important to you, and cross off those items that are not useful.
Make a copy of this checklist for each program that you plan to consider. Have the list in front of you as you ask questions of the hospice program staff, and make notes next to each item on your list.
Hospice Care Checklist
|
Name of hospice program:
|
|
Address:
|
City
|
State
|
Zip
|
|
Phone number:
|
|
Where are services provided?
|
| |
- In your home
- In a special inpatient hospice unit
- In a facility (hospital or nursing home) where you are already a patient
|
|
What services are provided?
|
| |
- One or more doctors who can make home, hospital, or nursing home visits
- Spiritual or religious counseling or advisors
- Respiratory, occupational, and physical therapists
- Social workers
- Home health aides
- Shopping and errands
- Meal preparation and nutritional counseling
- Cleaning and household chores
- Respite services if your primary caregiver becomes ill or needs a break
- Prescription medications, and medical supplies and equipment
- Interpreters or other special services related to your culture, ethnicity, or lifestyle
|
|
What is the plan of care?
|
|
Does the hospice program develop a care plan with you and your family?
|
Yes / No
|
|
The care plan should include specific duties, who will perform them and how often, and the name and phone number of the supervisor. A good program will develop a care plan by providing a health professional (not a clerk or administrative assistant) who will:
|
| |
- Talk with you and your family in your home (not just over the telephone).
- Talk with your doctor or other health professionals.
- Write down the care plan and give copies to everyone who will be involved in your care.
|
|
Who provides care?
|
| |
- Family members
- Hospice staff
- Your doctor
|
|
Licensing and certification
|
| |
Is the plan:
- Medicare-certified?
- State-licensed? All state health departments certify hospice programs.
- Accredited by one or more professional organizations? These may include:
- Accreditation Commission for Home Care, Inc.
- Community Health Accreditation Program.
- Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
- National Committee for Quality Assurance (NCQA).
|
|
Are the hospice nurses certified by the Hospice Nurses Association?
|
Yes / No
|
|
Are the hospice doctors certified by the American Board of Hospice and Palliative Medicine?
|
Yes / No
|
|
References
|
|
Get the names of doctors who refer patients to this program.
|
|
|
|
Identify families who have used this program. If possible, talk with the families. Ask about their experience and whether they would recommend the program to others.
|
|
|
|
After your visit
|
|
Does this program provide the services you want?
|
Yes / No
|
|
Is this program covered by your insurance?
|
Yes / No
|
Credits
Current as of: November 16, 2023
Current as of: November 16, 2023
