This section contains frequently asked questions and information about hospice care and services.  Often there are many questions regarding hospice services, how to access them, and what to expect from a hospice agency.  Whether you are a patient or family member, we hope that you will find this information helpful.

Admission Criteria

• Are you required to sign a “Do Not Resuscitate” order before being admitted
• Are you allowed to retain your personal physician?
• Will the hospice admit a patient without a primary caregiver? If so, what happens when the patient can no longer care for his/herself?
  
• Does the hospice have a provision to care for patients without Medicare and without insurance? How do you qualify for courtesy care if it exists? Does the hospice limit the number of courtesy care patients it admits? What services do courtesy care patients receive compared to patients with insurance?

Hospice Qualifications

• With what hospitals, nursing homes, and equipment companies is the hospice contracted?
• Is the hospice a member of the Oklahoma Hospice & Palliative Care Association, the National Hospice and Palliative Care Organization or the National Association of Home Care?
• Does the Joint Commission on Accreditation of Healthcare Organizations accredit the hospice?
• What were the results of the most recent survey by the Oklahoma State Department of Health? If any deficiencies were found, what were they, and what has been done to correct those deficiencies?
• Does the hospice measure family satisfaction with their service? How is it measured, and what are the results of the most recent survey?
• How long has the hospice been operating? 

How Does Hospice Care Work

Typically a family member serves as the primary caregiver and, when appropriate, helps make decisions for the terminally ill individual. Members of the hospice staff make regular visits to assess the patient and provide additional care or other services. Hospice staff is on call 24 hours a day, seven days a week.

The hospice team develops a care plan that meets each patient’s individual needs for pain management and symptom control. The team usually consists of:

• The patient’s personal physician
• Hospice medical director or physician
• Nurses
• Hospice aides
• Social workers
• Clergy or other counselors
• Trained volunteers and

Speech, physical, and occupational therapists if needed. 

How to Choose a Hospice

There are many hospices to choose from in the State of Oklahoma. Most hospices are individually owned, and not all hospices provide exactly the same services. Hospices are required by law to provide basic services, but how these services are provided and whether additional services are provided varies with each hospice. We suggest you interview several hospices before selecting one. Although your physician may suggest a particular hospice, you are free to choose whatever hospice you wish. If you or your loved one is a resident of a nursing home, you may be limited in your choice of hospices by the nursing facility. By law, the facilities are allowed to do this.

The Oklahoma Hospice & Palliative Care Association cannot recommend a particular hospice.

Services Provided

What bereavement services does the hospice offer and for how long? Are these services provided by the hospice or contracted out to another organization? Which family members and friends are included in the bereavement support? Does the hospice sponsor a support group of some kind?

• Does the hospice provide physical therapy, occupational therapy, speech therapy, and dietary counseling on a regular basis or only occasionally? How is the need determined?
• What medical equipment is typically provided to a patient? (Equipment can include fully electric hospital beds, alternating pressure mattresses, bedside commodes, walkers, wheelchairs, shower chairs, oxygen if ordered by your doctor, nebulizers if ordered by your doctor, and more.) How quickly can the equipment be delivered, and how is it maintained? What if there’s a problem with a piece of equipment “after hours”?
• How does the hospice determine what medications it will provide if the patient is enrolled in the Hospice Medicare Benefit?
• How often does each of the staff members visit the patient?
• How is on-call service provided after hours and on weekends? How rapid is the response?
• What is the hospice’s policy on palliative radiation and chemotherapy? How does the hospice define these therapies? 

Staffing

• How many patients are assigned to each hospice nurse? (The National Hospice and Palliative Care Organization recommends no more than 10-12 per nurse.)
• How many volunteers have been trained to work with patients and families? Are there enough volunteers to provide help to all the families who request them? What does the training consist of?
• How often will home health aides be provided to the patient? What are they going to do? (Most aides visit homes 3-5 times per week depending on the family’s needs, but can be assigned every day if necessary. These aides provide personal care, change bed linens, and can cook light meals for the patient.) Are the aides certified in hospice and palliative care?
• How many of the hospice nurses are certified in hospice and palliative care?
• What is the typical caseload for the social workers? (NHPCO recommends no more than 20-30 patients/licensed social worker.)
• What is the typical caseload for the chaplains? (NHPCO recommends no more than 40-60 patients/chaplain). 

To File a Complaint

Call the Oklahoma State Department of Health, 1-800-234-7258