Conduct careful and detailed research on your local hospice agencies. The internet is a good source of information about hospice agencies, since most have a website that describes both their operation and their philosophy of care.
You can also go here. The Texas Department of Aging and Disability Services (DADS) offers information on this wonderful website to help you evaluate the quality of long term care service providers, including hospice agencies, nursing homes and residential care homes. Note that you can review facility ratings, consumer complaints and discrepancies that State inspectors have recorded over the past several years for each facility or organization.
Friends and associates can be valuable sources of information as well since, in many cases, they have had personal experience with hospice agencies or know others who have. Your physician and your church will also have information on local hospice agencies.
Please bear in mind that all hospice agencies in Texas must be licensed by the state. State licensing, and the licensing inspections (or “surveys”), are conducted in cooperation with Medicare. For this reason, the state licensing requirements follow the Medicare hospice standards (“Conditions of Participation”) very closely. In other words, the state’s licensing standards for hospice agencies are essentially the same as the Medicare Conditions of Operation.
According to state and Medicare requirements, all hospice agencies must provide the same services. For this reason, your research must be more detailed, so you understand the personalities and cultures of the hospice agencies you consider.
Talk with the admissions coordinator at each of the hospice agencies you are considering. Questions you should ask include:
Are you state licensed and Medicare certified (if the patient will be using the Medicare Part A benefits)?
As mentioned above, all hospice agencies in Texas must be licensed by the state. If an agency offers services to Medicare patients, the agency must also be certified by Medicare.
Will the agency assign a specific RN case manager, social worker, chaplain and home health aide to the patient or will the agency rotate its staff members based on the agency’s convenience for staff scheduling?
Autumn Journey Hospice will assign specific professionals to each patient. We will not change staff members, if we can possibly avoid doing so, unless the patient or patient’s representative asks us to make a change.
Can I interview the specific staff members who will be caring for the patient?
This is an extremely important step in your research. You should become very knowledgeable and comfortable with the specific hospice staff members who will be coming to the home to provide care. It is in your, and the patient’s, best interests to know the people you will be working with during this critical time in the patient’s life. Preferred hospice agencies will be happy to allow you to do this.
Can you provide references from caregivers or family members who have worked with your agency and these specific staff members?
Some hospices will suggest that the privacy provisions of the HIPAA Act prevent them from doing this. Preferred hospices will be happy to provide this information, since they will have many families who have asked to be used as references for future patients.
Do you ever charge Medicare patients directly for any care, services, supplies, equipment, or prescription drugs that you provide?
Medicare allows hospice agencies to charge a 5% co-pay for each prescription provided to the patient. However, preferred hospices will not charge the patient for this and we NEVER charge our Medicare patients for this co-pay or any other item or service we provide.
Will my prescriptions, supplies and equipment be delivered to my home? Will there be any charge for delivery?
Preferred hospices will include this service at no charge. We provide home delivery for all prescriptions, medical supplies and medical equipment, including oxygen, at no charge.
Can you provide hospice care to patients residing in nursing homes?
The answer is yes…..in some, but not all, cases.
Before we explain our answer, you need to be aware of several facts:
- Title 42, Section 418.24 of the Code of Federal Regulations, gives Medicare patients the right to choose a particular hospice.
- Title 42, Section 418.56 of the Code of Federal Regulations requires hospice agencies to establish written working agreements with other entities that are jointly involved in patient care. The purpose of this regulation is to ensure that continuity of care is maintained.
- However, in the case of nursing home residents, the Code of Federal Regulations does not require nursing homes to sign working agreements with every hospice agency that residents may wish to use.
- If your nursing home does not choose to sign a working agreement with the hospice of your choice, then the nursing home MUST help you find a nursing home that does have an agreement with your hospice.
If having the ability to choose the hospice you want is important to you, you should ask the nursing home if they will allow your chosen hospice to provide service to you. Since all hospices that are State licensed and Medicare certified provide the same services, you should also ask the nursing home what criteria they use to choose particular hospices and exclude others.
Finally, our answer to the question. We will be able to provide hospice care to you, if we have a working agreement with your nursing home. If we do not have a signed working agreement, we will not be able to provide hospice care to you.
If I have questions or concerns that the RN Case Manager cannot answer, who is the agency point of contact (name and phone number) that I can talk to so I can resolve my concerns?
Preferred hospices will be happy to provide this information to you. At Autumn Journey Hospice you will always have immediate access to our Director of Clinical Services and our President.
Very simply, you choose a hospice agency in the same manner and with the same care that you would choose any product or service that will have a major influence on your life or the life of a loved one.