Site Search
About CHAM
Who We Are
Our Mission
Our Values
Standards of Excellence
CHAM Leadership
In the Community
News
Community Events
Inside CHAM
CHAM Connections
CHAM Mentions
Bronx Locations
US News & World Report
Health Library
Patient Health Library
Refer a Patient
Find a Doctor
Find a Clinical Trial
SIGN IN TO MYCHART
Ways to Give
Volunteer
Volunteering at CHAM
Why Support Montefiore
Donate
Specialties & Programs
Pediatric Specialties
View Specialties
Adolescent Medicine (Gynecology, Menstrual disorders, Contraception, Eating disorders, Obesity)
Allergy and Immunology
Anesthesiology
Cardiology (Heart)
Cardiothoracic Surgery (Heart)
Craniofacial Surgery
Critical Care Medicine
Dentistry
Dermatology (Skin Disorders)
Developmental Medicine (Developmental and Behavioral Pediatrics, Autism, ADHD, Developmental Delays and Mental Health)
Emergency Medicine
Endocrinology & Diabetes
Fetal Medicine (High Risk OB/GYN)
Gastroenterology and Nutrition (Inflammatory Bowel Disease, Liver Disease, Liver Transplant)
General Pediatrics (Academic General Pediatrics)
Genetics (Inherited Diseases, Rare Diseases, Genetic Counseling)
Heart
Pediatric Hematology, Oncology, and Cellular Therapy
Hepatology (Liver Disease)
Hospital Medicine
Infectious Disease (Vaccines, Complex Infection and Antibiotic Management)
Neonatology (Premature and Sick Newborn Care)
Nephrology (Kidney Disease, Hypertension, Dialysis, Kidney Transplant)
Neurology (Seizures, Neuromuscular and Brain Diseases, Muscular Dystrophy, Rhett Syndrome)
Neurosurgery
Ophthalmology (Eye and Vision)
Orthopedics (Bones and Joints)
Otolaryngology (Ears, Nose, Throat)
Plastic Surgery
Psychiatry (Therapy for Mental Health Problems, Depression, Psychiatric Diseases)
Radiology,X-rays, ultrasound, MRI, CT, interventional procedures
Respiratory and Sleep Medicine (Lung and Breathing Problems, Asthma, Sleep Apnea)
Rheumatology (Lupus, Juvenile Arthritis, Childhood Autoimmune Diseases)
Surgery
Urology (Kidney, Ureter and Bladder)
PROGRAMS & CENTERS
View All Programs & Centers >
For Patients & Families
Getting Here
Your Hospital Visit
Neighborhood Services
Visitors
Community Events
Support Services
Paying For Your Visit
FAQs
Find A Doctor
Get Directions
For Health
Professionals
Refer A Patient
Residency and Fellowship at the Children’s Hospital at Montefiore
Nursing At CHAM
Grand Rounds
Careers
L.E.A.D. Program
Staff & Alumni Association
Quality & Performance Improvement
CHAM Leadership
Medical Student Education
Clinical Pathways
Research
Child Health Research at CHAM
Improving Child Health Across Disciplines
Clinical Trials
Albert Einstein College Of Medicine
Preventive Intervention Research Center for Child Health (PIRC)
Home
Health Library
Share
Health Library
<div class="HwContainer HwElement" id="HwContainer"><a class="HwMainSkipNavigation" href="#HwContentTitle"><span class="HwAccessibilityText">Skip Navigation</span></a><div class="HwBlock" id="HwMain" role="main"><div class="HwRow"><div class="HwColumn" id="HwColumnSidebar1"><div class="HwCustom" id="HwCustomSidebar"> </div></div><div class="HwColumn" id="HwColumnContent"><div id="HwContentTop"> </div><div class="HwTypeFocus HwContentWrapper HwElement" role="article" id="HwContentWrapper"><div class="HwCustom" id="HwCustomContentTop"> </div><div class="HwContentHeader"><p><a name="top" id="Hwtop"><span class="HwAccessibilityText">Top of the page</span></a> </p></div><div class="HwContentTitle"><h1 id="HwContentTitle" tabindex="-1">Checklist for Evaluating Hospice Programs</h1></div><div class="HwContentTopNavigation"> </div><div class="HwContent"><div class="HwNavigationSection HwSectionFloat" id="sec-aa114499-sec"><h2 class="HwSectionTitle" fingerprint="421b88ad" fingerprint-exact="1b206d13">Topic Overview</h2><p fingerprint="dd58c1dd" fingerprint-exact="a1df1dee">Once you make the decision to seek hospice care, make your search easier by using this checklist to find out about different programs. Add to it as you think of items that are important to you, and cross off those items that are not useful. </p> <p fingerprint="0451d24a" fingerprint-exact="310fbc1e">Make a copy of this checklist for each program that you plan to consider. Have the list in front of you as you ask questions of the hospice program staff, and make notes next to each item on your list. </p> <table class="hw-preformatted hw-table-border" fingerprint="7642d240" fingerprint-exact="6385d0ed"> <caption>Hospice Care Checklist</caption> <colgroup> <col width="1%"> <col width="2%"> <col width="3%"> <col width="4%"> </colgroup> <tbody> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p> <b>Name of hospice program:</b> </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top"> <p>Address: </p> </td> <td class="hw-align-text-left hw-align-text-top"> <p>City </p> </td> <td class="hw-align-text-left hw-align-text-top"> <p>State </p> </td> <td class="hw-align-text-left hw-align-text-top"> <p>Zip </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p>Phone number: </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p> <b>Where are services provided?</b> </p> </td> </tr> <tr> <td class="hw-align-text-right hw-align-text-top"> </td> <td class="hw-align-text-left hw-align-text-top" colspan="3"> <ul> <li>In your home </li> <li>In a special inpatient hospice unit </li> <li>In a facility (hospital or nursing home) where you are already a patient </li> </ul> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p> <b>What services are provided?</b> </p> </td> </tr> <tr> <td class="hw-align-text-right hw-align-text-top"> </td> <td class="hw-align-text-left hw-align-text-top" colspan="3"> <ul> <li>One or more doctors who can make home, hospital, or nursing home visits </li> <li>Spiritual or religious counseling or advisors </li> <li>Respiratory, occupational, and physical therapists </li> <li>Social workers </li> <li>Home health aides </li> <li>Shopping and errands </li> <li>Meal preparation and nutritional counseling </li> <li>Cleaning and household chores </li> <li>Respite services if your primary caregiver becomes ill or needs a break </li> <li>Prescription medications, and medical supplies and equipment </li> <li>Interpreters or other special services related to your culture, ethnicity, or lifestyle </li> </ul> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p> <b>What is the plan of care?</b> </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="3"> <p>Does the hospice program develop a care plan with you and your family? </p> </td> <td class="hw-align-text-left hw-align-text-top"> <p>Yes / No </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p>The care plan should include specific duties, who will perform them and how often, and the name and phone number of the supervisor. A good program will develop a care plan by providing a health professional (not a clerk or administrative assistant) who will: </p> </td> </tr> <tr> <td class="hw-align-text-right hw-align-text-top"> </td> <td class="hw-align-text-left hw-align-text-top" colspan="3"> <ul> <li>Talk with you and your family in your home (not just over the telephone). </li> <li>Talk with your doctor or other health professionals. </li> <li>Write down the care plan and give copies to everyone who will be involved in your care. </li> </ul> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p> <b>Who provides care?</b> </p> </td> </tr> <tr> <td class="hw-align-text-right hw-align-text-top"> </td> <td class="hw-align-text-left hw-align-text-top" colspan="3"> <ul> <li>Family members </li> <li>Hospice staff </li> <li>Your doctor </li> </ul> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p> <b>Licensing and certification</b> </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top"> </td> <td class="hw-align-text-left hw-align-text-top" colspan="3"> <p>Is the plan: </p> <ul> <li>Medicare-certified? </li> <li>State-licensed? All state health departments certify hospice programs. </li> <li>Accredited by one or more professional organizations? These may include: <ul><li>Accreditation Commission for Home Care, Inc. </li> <li>Community Health Accreditation Program. </li> <li>Joint Commission on Accreditation of Healthcare Organizations (JCAHO). </li> <li>National Committee for Quality Assurance (NCQA). </li></ul></li> </ul> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="3"> <p>Are the hospice nurses certified by the Hospice Nurses Association? </p> </td> <td class="hw-align-text-left hw-align-text-top"> <p>Yes / No </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="3"> <p>Are the hospice doctors certified by the American Board of Hospice and Palliative Medicine? </p> </td> <td class="hw-align-text-left hw-align-text-top"> <p>Yes / No </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p> <b>References</b> </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p>Get the names of doctors who refer patients to this program. </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <br> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p>Identify families who have used this program. If possible, talk with the families. Ask about their experience and whether they would recommend the program to others. </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <br> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <br> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="4"> <p> <b>After your visit</b> </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="3"> <p>Does this program provide the services you want? </p> </td> <td class="hw-align-text-left hw-align-text-top"> <p>Yes / No </p> </td> </tr> <tr> <td class="hw-align-text-left hw-align-text-top" colspan="3"> <p>Is this program covered by your insurance? </p> </td> <td class="hw-align-text-left hw-align-text-top"> <p>Yes / No </p> </td> </tr> </tbody> </table></div><div class="HwNavigationSection HwCreditsSection HwCreditsWithoutNavstack HwSectionCredits" id="sec-aa114499-Credits"><h2 class="HwSectionTitle">Credits</h2><div class="HwContentInformation"> <div class="HwLastUpdated"> <p> <span class="HwInfoLabel">Current as of: </span> October 18, 2021 </p> </div> <div class="HwCredits"> <p> <span class="HwInfoLabel">Author: </span>Healthwise Staff<br> <span class="HwInfoLabel">Medical Review: </span> <br> <span class="HwInfoName">Anne C. Poinier MD - Internal Medicine</span> <br> <span class="HwInfoName">Adam Husney MD - Family Medicine</span> <br> <span class="HwInfoName">Shelly R. Garone MD, FACP - Palliative Medicine</span></p> </div> </div></div></div><div class="HwCustom" id="HwCustomContentBottom"> </div><div class="HwContentNavigation"><div class="HwSectionNavItem" style="display:block" id="secNav-aa114499-sec"><ul><li class="HwContentNavigationNone"> </li><li class="HwContentNavigationTop"><a href="#top">Top of the page</a></li><li class="HwContentNavigationNext"><p>Next Section: </p><a class="HwLinkNavstack" data-hw-type="Focus" data-hw-document-href="aa114499" data-hw-section="aa114499-Credits" id="nextLink-aa114499-Credits" hw:document-type="Focus" hw:document-href="aa114499" data-hwid="aa114499" hw:section-href="aa114499-Credits" href="?id=aa114499#aa114499-Credits">Credits</a></li><li class="HwClear"> </li></ul></div><div class="HwSectionNavItem" style="display:none" id="secNav-aa114499-Credits"><ul><li class="HwContentNavigationPrev"><p>Previous Section: </p><a class="HwLinkNavstack" data-hw-type="Focus" data-hw-document-href="aa114499" data-hw-section="aa114499-sec" id="prevLink-aa114499-sec" hw:document-type="Focus" hw:document-href="aa114499" data-hwid="aa114499" hw:section-href="aa114499-sec" href="?id=aa114499#aa114499-sec">Topic Overview</a></li><li class="HwContentNavigationTop"><a href="#top">Top of the page</a></li><li class="HwContentNavigationNone"> </li><li class="HwClear"> </li></ul></div></div><div class="HwContentInformation" role="complementary"><div class="HwLastUpdated"><p><span class="HwInfoLabel">Current as of: </span>October 18, 2021</p></div><div class="HwCredits"><p><span class="HwInfoLabel">Author: </span><a class="HwLinkDisclaimer" href="https://www.healthwise.org/specialpages/legal/abouthw/en">Healthwise Staff</a></p><p><a class="HwLinkDisclaimer" href="https://www.healthwise.org/mdreviewboard.aspx?lang=en-us"><span class="HwInfoLabel">Medical Review:</span></a><span class="HwInfoName">Anne C. Poinier MD - Internal Medicine</span> & <span class="HwInfoName">Adam Husney MD - Family Medicine</span> & <span class="HwInfoName">Shelly R. Garone MD, FACP - Palliative Medicine</span></p></div></div></div></div><div class="HwColumn" id="HwColumnSidebar2"><div class="HwCustom" id="HwCustomNavigationTop"> </div><div class="HwElement" id="HwNavigationWrapper"><div class="HwNavigation" id="HwNavigation" role="navigation"><h3 class="HwNavStackHeader" id="HwNavStackHeader">Topic Contents</h3><ul aria-labelledby="HwNavStackHeader"><li id="nav-aa114499-Credits"><a class="HwLinkNavstack" data-hw-type="Focus" data-hw-document-href="aa114499" data-hw-section="aa114499-Credits" hw:document-type="Focus" hw:document-href="aa114499" data-hwid="aa114499" hw:section-href="aa114499-Credits" href="?id=aa114499#aa114499-Credits">Credits</a></li></ul></div></div><div class="HwNavigationWrapper HwNavigationEmpty"> </div><div class="HwCustom" id="HwCustomNavigationBottom"> </div></div></div></div><div class="HwBlock" id="HwFooter"><div class="HwRow"><div class="HwCustom HwColumn" id="HwCustomFooterLeft"> </div><div class="HwColumn" id="HwFooterLegal"><div class="HwLegal HwElement" role="contentinfo"><div class="HwLogo"><a class="HwLinkExternal" href="https://www.healthwise.org/specialpages/legal/abouthw/en"><img class="HwNoHcMode" data-hw-resource-path="media/interface/hwlogo.png" alt="Click here to learn about Healthwise" src="https://ixbapi.healthwise.net/Resource/13.3/en-us/media/interface/hwlogo.png" hw:resource-path="media/interface/hwlogo.png" hw:release-quarter="13.3"><img class="HwHcMode" data-hw-resource-path="media/interface/hwlogo_hc.png" alt="Click here to learn about Healthwise" src="https://ixbapi.healthwise.net/Resource/13.3/en-us/media/interface/hwlogo_hc.png" hw:resource-path="media/interface/hwlogo_hc.png" hw:release-quarter="13.3"></a></div><div class="HwDisclaimer"><p>This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the <a href="https://www.healthwise.org/specialpages/legal/terms.aspx">Terms of Use</a> and <a href="https://www.healthwise.org/specialpages/legal/privacy.aspx">Privacy Policy</a>. Learn <a class="HwLinkExternal" href="https://www.healthwise.org/specialpages/legal/abouthw/en">how we develop our content</a>.</p></div><div class="HwOptionalLogo"><div class="HwLogo"><a class="HwLinkExternal" href="https://www.healthwise.org/specialpages/legal/abouthw/en"><img class="HwNoHcMode" data-hw-resource-path="media/interface/hwlogo.png" alt="Click here to learn about Healthwise" src="https://ixbapi.healthwise.net/Resource/13.3/en-us/media/interface/hwlogo.png" hw:resource-path="media/interface/hwlogo.png" hw:release-quarter="13.3"><img class="HwHcMode" data-hw-resource-path="media/interface/hwlogo_hc.png" alt="Click here to learn about Healthwise" src="https://ixbapi.healthwise.net/Resource/13.3/en-us/media/interface/hwlogo_hc.png" hw:resource-path="media/interface/hwlogo_hc.png" hw:release-quarter="13.3"></a></div></div><div class="HwCopyright"><p class="HwCopyrightLink">To learn more about Healthwise, visit <a href="https://www.healthwise.org">Healthwise.org</a>. </p><p>© 1995-2022 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.</p></div></div></div><div class="HwCustom HwColumn" id="HwCustomFooterRight"> </div></div></div><div class="HwCustom HwBlock" id="HwCustomFooter"> </div></div>