How to choose a hospice: questions to ask before you sign
The short answer
Every Medicare-certified hospice follows the same basic rules, but they don't all run the same way. Before you sign, ask how often the nurse will visit, who answers at night and on weekends, how fast someone comes in an urgent moment, and what happens in a crisis at home.
General information, not medical advice. Your hospice team knows your person and can answer for your situation.
Do you have to take the first hospice that calls?
No. A hospital or doctor's office often suggests one hospice, and it can feel like the decision is made. It isn't. You can call two or three and choose the one that fits your family.
If it turns out to be the wrong fit, you have the right to change hospice providers once during each benefit period.
What questions show how a hospice really runs?
Brochures sound alike. Plain, practical questions show the differences. Ask:
- How often will the nurse visit at first, and how often will an aide come to help with bathing?
- Who answers the phone at 2 a.m. or on a Sunday? Is it a nurse?
- If we call with an urgent problem, how long until someone is at the door?
- What happens if symptoms get hard to control at home? Do you offer short-term inpatient care or extra hours of nursing?
- How do you arrange respite care if the caregiver needs a break?
- Will we have the same nurse most of the time?
- What support do you offer the family, before and after the death?
Write the answers down. Clear, unhurried answers tell you something.
How can you check a hospice's quality?
Medicare's Care Compare tool (Medicare.gov/care-compare) lets you look up Medicare-approved hospices near you and compare them.
One of the most useful parts is the family caregiver survey. Families who cared for someone who died in hospice care are asked how well the team communicated, whether they got help quickly when they needed it, including evenings and weekends, and whether they would recommend the hospice. Results show as a star rating along with the details.
Small or new hospices may not have results yet. That isn't a bad sign by itself, but your own questions matter more.
What should you confirm before you sign?
Signing the election form means your person chooses comfort care through hospice instead of treatment to cure the illness. Before you sign, make sure you know:
- The 24-hour phone number, and who will pick up
- When the first nurse visit will happen
- Which medicines, equipment, and supplies the hospice will provide
- Whether your loved one's regular doctor can stay involved
- If your person lives in a facility, how the hospice will work with the staff there, and that room and board is not covered by hospice
Read more about what Medicare pays for before you meet anyone.
What if you feel rushed?
Feeling pressure is normal. Even so, one call to a second hospice gives you something to compare.
Sources
- Medicare.gov, Hospice care: medicare.gov/coverage/hospice-care
- Medicare.gov, Medicare Hospice Benefits booklet: medicare.gov/publications/02154-medicare-hospice-benefits.pdf
- CMS, CAHPS Hospice Survey: cms.gov/medicare/quality/hospice/cahpsr-hospice-survey
Educational information only. This article is not medical, legal, or financial advice, and it can't account for your person's health or your state's rules. Always talk with your hospice team, doctor, or Medicare (1-800-MEDICARE) about your situation. If you think it's an emergency, call your hospice's 24-hour number or 911.