Hospice Patients Alliance: Consumer Advocacy


When the patient's symptoms become uncontrolled, hospices are set up to take an aggressive approach to overcoming these barriers to patient comfort. Hospices must assure the patient's comfort and if the patient resides in the hospice facility, extra staff or attention will be provided to make sure the patient's needs are met. In some instances, the patient may be temporarily placed in an acute care hospital (transferred from his home) if there is no hospice facility. This level of care is called "Inpatient Level of Care" and the hospice is reimbursed at three times the level that it receives when the patient is receiving the usual "Routine Home Care Level of Services."

At this level of care, you can expect individualized attention in an intense and moment to moment assessment of what's occurring and what needs to be done. There is often very close coordination between the hospice staff and the patient's Attending Physician who together work to achieve patient comfort. Medications may be changed or dosages may be adjusted, or ways of administering medications may be changed to attain an optimum effectiveness of the medications: all geared to helping the patient to be comfortable.

If your loved one is already residing in a hospice facility and the symptoms are uncontrolled, you can inquire about placing the patient on "In Patient Level of Services" so that he or she can get the special attention that may be required. This is especially important if you think your loved one's needs are being ignored. If the hospice appears short-staffed you need to speak with the RN in charge at the facility, then the facility's director, and if that is not effective, speak with the director of the entire hospice. Ask the director what they are doing to correct the situation.

If the situation is not corrected within a day or so, even after speaking with the hospice's director, then a complaint to your State's division of health facility licensing and certification is in order. You certainly cannot wait for a month or two while they tell you they're "trying" to hire someone. The hospice is certainly getting paid to provide adequate care, and they are required to do so! Saving money on staff at your expense and suffering is not what hospice is about. Unfortunately, there are some hospices that do purposely understaff their facilities and simultaneously pay their administrators handsomely....just as in other areas of health care! Be assertive.

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