The Diane Rehm show on NPR today had a panel discussion to react to a Washington Post article entitled “Dying and Profit: the Evolution of Hospice”. (http://wapo.st/1CZiHGc)

The Wall Street Journal article basically said that For-Profit Hospices offer sub-par care. Both the article and NPR panel, in my humble opinion, were both misleading and didn’t address the true issue which was “what do consumers need to know in selecting the best hospice for them?”

I have worked for both types of hospice companies and to be completely honest, there are good and bad in both. The big claim in the Washington Post article is that For-Profit hospices skimp on nursing visits. I have never found that the case. And there are some Not-For-Profit hospice who act more like fund-development companies than hospice providers. So, again, this calls out in a LOUD voice, “what criteria should people looking when selecting a hospice company that is best for them?”

Here are a few questions that every customer should ask a hospice company they are interviewing.

1. What is your turn-over rate in your organization? The national average is 15% for hospice companies. If the company you are interviewing has a higher turnover rate you need to understand why!
2. The average caseload for a nurse. The national average is 13 patients per nurse. Obviously this number is going to fluctuate based on the hospices’ census. This is a KEY question to ask and understand.
3. Are your physicians Board Certified in Hospice and Palliative Care Medicine. Just like you won’t go to a Family Practice Physician for Open Heart Surgery (you want a Board Certified Cardiovascular Surgeon), you want a physician who is Board Certified in Hospice and Palliative Care Medicine on the hospice company team you select.
4. Does the hospice have Full Time physicians? You want to know if the hospice you select has a full time Medical Director.
5. Does the hospice offer all 4 levels of hospice care? There are four levels of hospice care: Routine, Respite, Continuous Care and General Inpatient (GIP). Does the hospice you select offer all 4 levels of care? Ask for details in how they offer these 4 levels of care.
6. Does the hospice offer General Inpatient Hospice (GIP) care? The GIP level of care is the “ICU” of hospice care and is intended to care for patients who have break-through pain and symptom management issues. You need to know and understand how the hospice you select delivers this level of care should your loved one ever need this specialty type of hospice care.
7. Does the hospice offer Music Therapy? The basic hospice benefit does not require a hospice to offer Music Therapy. If the hospice you select offers Music Therapy they are far be on what the basic hospice benefit requires!!
8. How many volunteers does the hospice have? The use of volunteers is part of the Conditions of Participation a licensed hospice must offer. Ask how many volunteers the hospice has and how many volunteer hours the hospice provides per month.

These are a few questions that will help guide you in selecting the best hospice for your loved one and you. So it is NOT an issue of For-Profit vs. Not-For-Profit but rather which hospice company offers the most outstanding care. You, as a consumer, need to know what makes a hospice excellent, good, bad or just so-so. The answer to these questions will help guide you in your interview process as you select a hospice.