Hospices are Among America’s Most Important Care Providers

Within the hospice community, we have a shared vision of bringing the best that humankind can offer to all those individuals facing serious, advanced and life-limiting illness.

Choosing to elect hospice care is an important decision that can greatly benefit patients with life-limiting illness by improving quality of life and proving support to a patient’s family during a difficult time. For people living with a wide range of diagnoses including cancer, heart disease, dementias, lung disease, kidney disease, and other medical conditions, hospice is an opportunity to spend one’s last days in comfort and dignity.

Hospice is not a place, but rather a special kind of coordinated care that employs a multi-disciplinary care team to attend to a person’s physical, emotional and spiritual needs at the end of life.

For the more than 4,000 hospices that care for more than 1.6 million patients every year, hospice is a sacred calling.  Hospice professionals use the special skills and expertise to support patients and family caregivers during of the most challenging experiences we share as human beings.

A dedicated team of doctors, nurses, social workers, counselors, aides, spiritual caregivers, therapists, and volunteers work together in a team to address the patient’s and family’s identified needs. In addition, hospices help provide medications, supplies, equipment, hospital services, and additional helpers in the home, as appropriate.

The nurses and physicians who serve hospice patients are experts in their fields and are trained to use the latest medications and devices to help patients with pain and symptom relief. Additionally, physical and occupational therapists are available to assist patients to become as mobile and self-sufficient as possible and are often joined by specialists schooled in music therapy, art therapy, diet counseling, and other therapies.

Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it addresses these as well. Counselors, including spiritual caregivers, are available to ensure one’s spiritual needs are taken care of.

Patients and families should not hesitate about discussing their end-of-life wishes and options for care with medical providers. One of the best ways to choose a hospice is to ask questions. A local hospice provider should be more than willing to help you understand their services and how they might be appropriate for your specific situation.

To learn more about hospice and palliative care, I encourage you to visit NHPCO’s CaringInfo.org website. Additionally, NHPCO offers a worksheet on Choosing a Quality Hospice (PDF) and an online Find a Provider Tool to help people get the information they need when facing serious and life-limiting illness.

A recent episode of CNBC’s American Greed shared the story of a hospice organization that failed to live up to the trust given as a Medicare certified provider. This disturbing story does not reflect the standards of excellent and commitment to quality that can be found throughout our nation’s community of hospice providers.

As the President and CEO of the National Hospice and Palliative Care Organization, I am proud to represent a provider community that is tasked with such an important responsibility and commend the vast majority of hospice providers in the U.S. who not only meet but exceed the high standards of care that hospice patients and their families expect and deserve.

By Edo Banach, JD
President and CEO
NHPCO

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Hospice Quality and Compliance Sidebar 

The National Hospice and Palliative Care Organization (NHPCO) has been a leader in aiding and assuring provider compliance with federal policies that protect and enhance the patient and family experience. 

Compliance and Quality are Not Optional

• The federal Hospice Conditions of Participation provide the minimum standards for care provision and all providers should not only meet but exceed the COPs. 
• If hospice programs are abusing the system, then they ought to be singled-out and their practices corrected or they should no longer provide hospice care.

NHPCO and Hospice Community Support Safeguards and Appropriate Surveys 

• NHPCO, working on behalf of the hospice community, advocated for legislation that brought timely and appropriate surveys of hospice providers at least every three years. 
• NHPCO is committed to providing tools and resources to ensure that hospice providers understand the ever-changing regulations for the field and are compliant. 
• NHPCO, on behalf of the hospice community, continues to work closely with both MedPAC (a Congressional advisory body) and the Centers for Medicare and Medicaid Services (the hospice community’s principal regulator) to identify problems and fashion responsible and reasonable safeguards to correct gaps in the regulations.

 Care of the Dying is Complicated

• The Medicare hospice benefit requires a six-month prognosis in order for a person to begin care – but that should not be confused with a limit to care. Misunderstandings about the “six-month rule” have long been considered a barrier to timely access to hospice. 
• People do not come with an expiration date, nor does their end-of life-care. Predicting a six- month life expectancy, even on an ongoing basis as required by the federal hospice regulations, is a complex and inexact art and science. 
• While hospices once cared predominantly for cancer patients at life’s end, providers now are skilled at caring for a wider range of patients with multiple complex conditions.