Nobody wants to make this decision. Choosing a hospice provider means accepting that someone you love is nearing the end of life, or that you are. Most families have never done it before, and there is no practice run. A few clear questions can cut through the confusion and help you judge one provider against another.
Start with licensing and certification
Any hospice you consider should be licensed to operate in Nevada and certified by Medicare. Certification matters for two reasons. It means the hospice meets federal standards for care, and it means Medicare can pay for the care. Ask to see the license and the Medicare certification. A provider that hesitates to show them is telling you something.
Ask who actually provides the care
Ask whether the nurses and aides who visit your home are the hospice’s own staff or workers supplied by an outside agency. There is no single right answer, but you should know who employs the people coming through your door, who supervises them, and who you call when something goes wrong. Accountability is easier to follow when the chain is short and clear.
Confirm the levels of care
Medicare defines four levels of hospice care, and a provider should be able to explain all four in plain language:
- Routine home care. Regular visits where the patient lives, at home, in an assisted living community, or in a nursing facility.
- Continuous home care. Extended nursing care at home during a short crisis, such as uncontrolled pain.
- General inpatient care. Short-term care in a facility when symptoms cannot be managed at home.
- Respite care. A short stay that gives the family caregiver a break.
Ask how each level works, who decides when a level changes, and how quickly that can happen at 2 in the morning.
Ask what is covered, and what is not
Hospice care is usually paid for by Medicare, Medicaid, or private insurance rather than out of pocket. Confirm the provider accepts your coverage before care starts, and ask what coverage includes: medications related to the terminal illness, medical equipment such as a hospital bed, supplies, and team visits. Under Medicare there are two small exceptions worth knowing about: a copay of up to $5 per prescription for outpatient drugs, and a 5 percent coinsurance for inpatient respite care. Everything else related to the hospice diagnosis is covered, including room and board exclusions to be aware of if your loved one lives in a nursing facility, since Medicare does not pay room and board there.
Ask about the team and the doctor
Every hospice patient has a team. Ask who is on it. At Shining Light Hospice, the team is nurses, aides, a social worker, a chaplain, and physician oversight. Ask how the hospice physician works with your loved one’s own doctor, because the patient’s doctor can stay involved in the plan of care if the patient wants that. Ask how care plans are reviewed and how often a nurse visits in a typical week.
Questions worth asking any provider
- How quickly can care start after we call?
- Who comes to the home for the first visit?
- What happens at night and on weekends? (At Shining Light, phones are answered around the clock, with an on-call nurse.)
- What does respite care look like if the family caregiver needs a break?
- How do you support the family after the patient dies? (Shining Light provides bereavement support for 13 months, longer on request, through calls and mailings.)
- Can you care for someone with more than one serious condition?
- If faith matters to our family, how does the chaplain work with us, including with our own clergy?
Make the call
You do not need to have every answer before you phone a hospice. A good provider will explain its answers without pressure and without a sales pitch. If you are comparing providers in the Las Vegas area, Shining Light Hospice serves Las Vegas, Henderson, Summerlin, North Las Vegas, Boulder City, and Pahrump, and checks your coverage before care starts. Call 702-906-0044 any time, day or night, and ask your questions directly.
