Many families are in a difficult place in their lives when the time comes to consider hospice. Stress, urgent situations and heightened emotions can make finding the best hospice agency challenging.
There are several factors to consider. One of the most important ones is quality. Learning about hospice quality measures can help you make an informed choice, so your loved one gets the end-of-life care they deserve.
Why Quality Matters
Most hospices offer the same basic services, but this does not mean all hospices are the same. A little research can help you make the best choice for your loved one. Choosing a hospice agency that is recognized for exceptional care can help increase their likelihood of:
- Achieving their goals (for example, having less pain or being able to spend time with family)
- Having their wishes honored
- Staying as comfortable as possible at home
- Experiencing better quality of life
- Identifying pain or other symptoms early, which can help them get additional care and prevent unnecessary trips to the hospital
- Understanding their condition and medications, which can also reduce their risk of an unplanned visit to the hospital
- Getting care from experienced professionals, who want to work at the best hospice companies
[action 1]
Understanding Hospice Quality Measures
Several objective indicators of quality can help you choose the best hospice organization for your loved one’s needs. These measures cover things like how well the agency cares for its patients and communicates with the family. They also describe how other patients and families rate their experience.
The Centers for Medicare and Medicaid Services (CMS) reports on hospice quality measures on the Care Compare website. In general, higher percentages are better. You can compare hospice companies to each other and to the national average. There are two types of hospice quality scores:
1. CAHPS Hospice Survey
Family caregivers complete this national survey to assess the patient and family’s satisfaction with hospice care. It is part of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) family of surveys. Developed by CMS, the CAHPS Hospice survey evaluates hospice providers based on the following measures:
- Communication with the family, such as listening, explaining and keeping them up-to-date
- Getting timely help when they needed it, including nights, weekends and holidays
- Treating the patient with care and respect
- Emotional and spiritual support during hospice and after their loved one dies
- Help for pain and symptoms like trouble breathing, anxiety and sadness
- Training the family to care for the patient (for example, discussing side effects and how to manage symptoms and medications)
- Overall rating of hospice care
- Willingness to recommend the hospice provider to others
2. Hospice Item Set (HIS)
The Hospice Item Set measures the quality of patient care based on medical record data. It assesses the percentage of patients who:
- Were treated with an opioid if given care for constipation
- Were screened for pain at the beginning of hospice care
- Received a timely and thorough pain assessment when pain was identified as a problem
- Were checked for shortness of breath at the beginning of hospice care and received timely treatment
- Were asked about preferences for life-sustaining treatments, such as hospitalization and resuscitation, at the beginning of care
- Were asked about spiritual beliefs and values at the beginning of hospice care
- Received at least one visit from a doctor or nurse in the last three days of life, and at least two visits from a hospice team member in the last seven days of life
- Received all care processes captured in this list of quality measures
3. Awards and Recognitions
The best hospice agencies often earn objective, third-party recognitions. The main type of award hospice organizations can receive is the SHPBest Award. This annual award acknowledges hospice agencies that consistently show a commitment to high-quality service and patient and family satisfaction, based on data from the CAHPS Hospice survey. The SHPBest award has three categories:
- Best-of-the-Best Award – the hospice facility with the best overall score
- Premier Performer – top 5% of hospice companies nationwide
- Superior Performer – top 20% of hospice organizations nationwide
How to Check a Hospice Facility's Quality Scores
Where can you find these quality measures so you can start comparing hospices for yourself? Here are a few tips:
Check Care Compare
Medicare’s Care Compare website (formerly called Hospice Compare) allows you to check quality scores and do a side-by-side comparison of the hospice agencies you’re considering.
Ask Your Loved One's Doctor
Healthcare providers can help you navigate your hospice options. If your loved one’s doctor recommends a specific hospice agency, know that you’re free to choose the provider you feel will best meet your needs. When making this decision, be sure to research hospice quality scores.
Call Hospice Agencies
Any provider you’re considering should be able to describe their quality scores and how they stack up against others. Talking to a hospice specialist will also give you insight into the agency’s other strengths that may not be captured in hospice quality scores.
Quality matters with any type of health care, including hospice. Your loved one may be more likely to get the care they need with a high-quality hospice provider. If the need for hospice arises, take a couple minutes to research quality, so you can find the very best care for your family’s needs.
Call an Amedisys care center near you to learn about our commitment to high-quality hospice care.
Reviewed by Laurie Brown, RN, BSN, MSN, CHPN, Hospice Clinical Education Specialist
