How to resolve a problem with your hospice - patient empowerment
This is intended to be informational to people who want to know how to handle a complaint about a hospice provider. Most hospices want to resolve your problem and will work with you to correct it. Communication is key and most hospices will be eager to resolve any difficulty. This information is specific to the US.
Problem with a staff member or minor issues that do not impact the quality of care: Call your hospice and ask to speak to the director of nurses, the clinical manager or the administrator. You don't have to be specific about the complaint unless you want to, you can simply say that the person providing care doesn't fit well with the personalities in your home if it is a personal issue. Often the hospice will simply offer to replace the staff member with another. Other issues regarding supplies, equipment, staff availability are usually quickly and easily resolved in this manner.
Hospice is not providing a medication/item/service that is related to the terminal diagnosis: You may request an addendum which is a document that lists everything that the patient requires that is covered by hospice and also what the patient takes or requires that is not covered by hospice. Part of requesting an addendum includes information on what to do if you disagree with the hospice determination on what is related. There is an advocate that can be assigned as well as an appeals process.
A problem occurs that results in a poor outcome for your family member: This is the time to be specific. Call your hospice and ask to speak to a clinical manager. Use the word "complaint" because all complaints of this nature must be documented and addressed. Provide specific details on what happened and why you think that the situation that occurred resulted in a poor outcome. Problems of this type might include requesting an after hours visit and no timely response, medication problems, an aide being rough with care without being malicious, poor response to requests for symptom control by the hospice staff. These are just examples and problems like these are rare but they do occur.
A serious error was made or a problem occurred that cannot be resolved by speaking to clinical leadership within the hospice: You have two options and you can choose one or both. The first is to switch hospices. A hospice transfer is easy to do and can be done once per hospice certification period. The second option is to find out what agency provides accreditation to the hospice. The accrediting agency name and phone number will be on your copy of the consent paperwork you signed when hospice services began or you can ask the hospice for the information. You may make a complaint to the accrediting agency and they will investigate. If it is found that the hospice did not meet the basic standards of care, the agency will provide the hospice with a plan of correction and the hospice is accountable to provide training and implement changes in order to make sure that the problem does not reoccur.
Posted Mar 14, 2022, 6:05 PM UTC
These are great steps. Some more suggestions. First, document, document, document. If you talk to someone, get a name, date of conversation and some details (E.g. Talked to Bob on 25th March at 3 PM on the phone and he promised that he would have this equipment ordered by the next day). If they send you an bill or statement, keep copies of that.
If it gets to a point where you have to go Accrediting agency, or local AG's office or even Medicare, the more documentation you have, the stronger the case. Even when you go to the higher ups in the hospice, the fact you have documented everything will generally make them more responsive.
Second, the more professional you are, the more effective you will be. Stand your ground, but stick to facts and do not get emotional. If you start cursing or attacking them personally etc., they will get defensive and not be cooperative and this will weaken your position.