How to Choose a Medicare Hospice Service Provider

Medicare beneficiaries have the right to choose the hospice that best fits their individual needs. Medicare hospices, and there are many in the Phoenix area, must all follow the same regulations as set forth by Medicare in the hospice Conditions of Participation (www.cms.gov) and each is paid the same amount for hospice services, also set by Medicare. In interviewing different hospices, you should hear about the same answers to your questions from each one.

If the answers should be similar, based on the Medicare regulations, how do you decide which hospice is the one to provide your end of life care? Here are some additional questions to ask yourself and the hospice representative that may help you decide:

Professionalism: Does the staff present themselves professionally and do they convey an expertise in their hospice knowledge? Do they have a respectful and courteous demeanor? Do they take their time in answering your questions with a feeling of really being present at the visit and listening to your particular needs and wishes?

Eligibility Guidelines: Were the guidelines for meeting hospice eligibility, created by Medicare, explained in detail to you? Often, there is more than one diagnosis, so were the distinctions explained using the guidelines? Do you know what will be considered the diagnosis for hospice care? Does this diagnosis seem to be an accurate one for Medicare to bill for the hospice services?

Size of the Hospice: What geographical areas are covered by the hospice? Do you prefer a smaller hospice or a large one? Do they have enough staff for the size of the hospice to meet your specific needs?

Inpatient Units: All hospices must have inpatient facilities available for people in crisis. Where are these facilities for the hospice located? Does the hospice own the facility or contract the services?

For Profit versus Not-for-Profit: Is this status important to you? Can the agency explain the difference? Medicare reimburses all agencies a standard per diem rate, regardless of tax filing status.

Medicare reimburses all agencies a standard per diem rate, regardless of tax filing status. (profit/not-for-profit)

Community: Does the hospice give back to the community at large? If so, how? Is the hospice locally owned and operated? Is there a non-local corporate entity that directs the hospice? Who owns the hospice? Is the hospice a member of any national hospice organizations?

Experience: What is the average hospice experience of the staff? Are they certified as professionals in hospice? Does the hospice have accreditation through an agency other than Medicare? When was the last hospice survey and were there any deficiencies? Arizona law requires agencies to make copies of survey results available upon request.

Expectations: What can you expect in a routine staff member visit? How long will each visit last? Are you able to suggest the frequency of staff visits? What can you expect the response time to be if you call the hospice? Is there a Registered Nurse to make emergency visits when an emergency arises?

Specialties: Does the hospice participate in any specialty program or have any special focus areas that are important to you? For instance, Veterans, Alzheimer’s support groups, pediatrics.

End of life care can be overwhelming at times and choosing a hospice can be too. Deciding who will help you is a very personal decision and the decision is always yours. Don’t hesitate to ask as many questions as you have to help you decide what hospice is right for your individual needs.