Hospice Patients Alliance: Consumer Advocacy


Hospices are organized for the purpose of serving the terminally ill and their families or care givers. They are reimbursed for these services by government payors such as Medicare, Medicaid or by private insurance companies. The more patients they enroll in their program, the better their bottom-line profits look. Staff salaries for services provided are the major cost in serving the public. From the strictly business perspective, any way salaries and benefits can be cut will improve the bottom line.

Of course, to remain in business, hospices must hire enough staff to provide care to all the patients they enroll. To attract staff and patients, they must maintain a positive public reputation. But some hospices may cut corners to improve their financial status. Obviously, the agency believes that: any violations the hospice is involved in must be covered up and suppressed, and the media must not publicize the violations. How is this accomplished? By getting local big-businessmen to participate on their Board of Directors...people from the major industries, the universities, the movers and shakers in politics. Involving the bigwigs from local news media is also important. Buying big ads in the papers will help squelch controversial stories from getting published...the papers look at their bottom line too!

When you or your loved one approach a hospice for care, they will certainly tell you about all the wonderful programs they have to help you. The most important question you need to answer is: Will this hospice be there when we need them? Will they fulfill their duty and provide quality hospice care and all that entails? You need to get personal references from people you know who have used a hospice recently. Compare programs, compare staffing, compare the literature provided and ask questions.

Hospices are service oriented. But hospice administrators are business oriented. They have to be in today's competitive environment; hospices compete for referrals from physicians, hospitals, and nursing homes. The biggest hospice may not be the best...it may simply be the pushiest, the most aggressive, the most politically connected, or the biggest advertiser...none of which guarantees quality. Reputation among those you know is the best indicator of a hospice's quality.

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