Problems and Complaints About Hospice:
What To Do
While we all hope that you won't encounter any problems in
hospice care, the reality is that problems can and do occur. Any
problems you encounter which arise out of the hospice care being
provided should be mentioned promptly to the RN case manager
assigned to your loved one's case. Clear communication about
what the problem is can go far to resolve many problems. Most
hospice staff are extremely dedicated and caring and will do
whatever they can to help you.
Problems with symptom management and pain control should be
immediately called in to the RN case manager. If it is after
regular office hours, then you should call the hospice's
on-call nurse for advice. Sometimes a little information on how
the physician allows you to adjust the medications being given
will help you know how to deal with a situation that arises.
Sometimes certain medications may need to stopped, while others
may need to be given without fail on a regular basis every few
hours.
The hospice is required to make an RN available to come out at
any time to assist you and your loved one if needed for symptom
management or pain control. Hospices have nurses
"on-call" whose job is to visit patients after hours
and over night if necessary. They are experienced in dealing with
the types of crises that can occur in terminal illnesses. Do not
be hesitant to call. The hospice will give you a telephone number
which you can call at any time after regular office hours for
assistance.
If you find that your loved one is still in pain or
experiencing distressing symptoms, even after clearly
communicating with your RN case manager or attending physician,
then you need to speak with the hospice's Medical Director
yourself. The Medical Director is authorized to intervene on
behalf of your loved one and give medical orders for medications
or treatments if necessary. You also have the right to change
physicians if necessary to get the care that is necessary to
maintain your loved one's comfort and relief from distressing
symptoms. If the hospice Medical Director does not intervene, you
can speak with the hospice's manager directly. In any case,
should all these attempts fail, federal law guarantees you the
right to change to another hospice of your choice.
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It is important that you write down any complaints you have
about a hospice. Writing it down will help clarify the issues.
Always remember to include the dates, names of persons involved,
the hospice ID/case # for your loved one, and any relevant
information. Clearly list the problems which occurred. Complaint
about a hospice can be sent to the hospice's management for
feedback. In addition, if the problems appear to be due to poor
management, negligence or even intentional management policy, you
should make a written complaint to your State's Bureau of
Health Systems or Department of Health Services (names vary from
State to State).
See the "State by State Address
Directory of Licensing Offices" for making a complaint
to your State's administrative offices. It is extremely
important that you mail your complaint by U.S. Certified and
Return Receipt mail: in writing, dated, signed and with a return
address and phone number so they can contact you for more
information if necessary. You can include the hospice's own
patient ID # for your loved one to help the State locate the
correct medical record. It is wise to send complaints by
certified/return receipt U.S. mail so that you have a record that
the State received your complaint and you can prove it if
necessary. You may use the complaint form at this website if you
wish: Click here to see the complaint
form. You can print this form out and use it to send to the
appropriate government agency in your state.
If within one month you don't receive any confirmation
from the State itself that they received your complaint, directly
telephone the Department which inspects and surveys hospices to
see if they received your complaint. Your persistence can help
improve hospice care for other patients and families. You may be
reluctant to go to the trouble of making a complaint, but not
making a complaint is the reason so many problems continue to
exist! By officially making a complaint, you will be helping to
stop these problems in the future. We urge you to voice your
concerns in writing and let other people know. Health care will
only improve if you and others speak up. You can make an
important differerence.
If you believe that services were not provided to you which
should have been provided, this can also be included in a
complaint to the State. Because hospices are reimbursed on a
per-diem basis, meaning they get paid for every day your loved
one is in the program, they are obligated by law to provide all
services you need for the care and treatment related to the
terminal illness. If you needed or have requested certain
services which you know were appropriate and the hospice still
failed to provide that service, health care fraud may be
occurring and should be reported to the regional U.S. Office of
the Inspector General and U.S. Attorney's office for your
area. (See the section on Links to
Report Fraud).
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