An Explanation of Palliative Care
NHPCO uses the National Consensus Project's definition of Palliative care.
Palliative care is patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information and choice.
The following features characterize palliative care philosophy and delivery:
- Care is provided and services are coordinated by an interdisciplinary team;
- Patients, families, palliative and non-palliative health care providers collaborate and communicate about care needs;
- Services are available concurrently with or independent of curative or life-prolonging care;
- Patient and family hopes for peace and dignity are supported throughout the course of illness, during the dying process, and after death
Community Based Palliative Care
Community-based palliative care includes a variety of models of care designed to meet the needs of seriously ill individuals and their families, outside of the hospital setting.
Clinical Practice Guidelines for Quality Palliative Care Released - On March 26, 2013 the National Consensus Project for Quality Palliative Care released the "Clinical Practice Guidelines for Quality Palliative Care, 3rd edition," which can serve as a blueprint for creating new palliative care programs and guiding developing programs. The guidelines describe elements of best practices for eight practice domains: structure and processes of care; physical aspects of care; psychological and psychiatric aspects; social aspects of care; spiritual, religious, and existential aspects of care; cultural aspects of care; care of the patient at the end of life; and ethical and legal aspects of care. NHPCO served on the consensus project task force, composed of representatives from AAHPM, CAPC, HPNA, NPCRC, NASW and NHPCO. The guidelines are available for free download at www.nationalconsensusproject.org
"Palliative Care: The Relief You Need When You’re Experiencing the Symptoms of Serious Illness," is a new brochure produced by the National Institute of Nursing Research (November, 2009).
Clinical Practice Guidelines for Quality Palliative Care, Second Edition – was released March 25, 2009 at the Annual Assembly of the American Academy of Hospice and Palliative Medicine (AAHPM) and Hospice and Palliative Nurses Association (HPNA), held March 25-28, 2009, in Austin, TX. Edited by Constance Dahlin, MSN, ANP, BC, ACHPN, who chaired the Revision Task Force, with input from representatives of each of the four major organizations in end of life –AAHPM, HPNA, NHPCO, and the Center for Palliative Care (CAPC) – the revised publication includes a new feature – exemplars of how hospice and palliative care professionals around the country have implemented the eight NCP domains of care in their practice settings. The Clinical Practice Guidelines for Quality Palliative Care, Second Edition will be available at the end of March in PDF format for free download from the NCP Web site. Print copies will sell for $34.99 and can be purchased at the NHPCO Marketplace.
Legal and Regulatory Resources
- Corporate Practice of Medicine Doctrine - 50 State Survey Summary
Palliative Care Checklist: Selected Regulatory and Risk Management Considerations – NHPCO resources mentioned within this Palliative Care Checklist are made available here on this webpage. The following is a list of web links mentioned in the Palliative Care Checklist that will redirect you to the Centers for Medicare & Medicaid Services (CMS) website or the Office of Inspector General (OIG) website:
- Program Memorandum Intermediaries, Transmittal A-02-102, "Medicare Certified Hospices-Clarification of Acceptable Parameters for Some Contractual Arrangements" (October 25, 2002).
Enrollment Forms and Information:
- Visit the CMS Web site to obtain a Medicare Part B enrollment form (Form 855B) and information regarding becoming a Medicare Part B provider.
- Hospices will need to submit their enrollment form to the Medicare carrier for their region. A listing of the Medicare carriers and their regions is available online.
- OIG Advisory Opinion No. 00-3 (April 7, 2000)
- Palliative Care: The Legal and Regulatory Requirements
- Palliative Care: The Legal and Regulatory Requirements – Part II
- “Hospice and Palliative Physician Group: Examining the Issues” by Connie A. Raffa. NewsLine, August 2004
- “Legal Issues to Consider When Creating a Health Care Business Model”, by Connie A. Raffa, JD, LLM
- Palliative Care Services: Selected Legal and Regulatory Considerations, April 2006
- Sample Palliative Care Services Agreement
Articles of Interest
- Study of Hospice-Hospital Collaborations -- This study, conducted by the Center to Advance Palliative Care in partnership with NHPCO and the Hospice Association of America, investigated the extent to which hospice is expanding its reach beyond patients under the hospice benefit and identified information that can be used to facilitate the further development of hospital-hospice collaborations.
- Hospital-Hospice Partnerships in Palliative Care: Creating a Continuum of Service Brochure -- A joint project of the National Hospice and Palliative Care Organization and the Center to Advance Palliative Care. Means to a Better End: A Report on Dying in America Today
- Questions and Answers
- Physician Board Certification in Hospice and Palliative Medicine - information provided by ABHPM