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.
Resources of Interest
Clinical Practice Guidelines for Quality Palliative Care, 3rd edition, was released in 2013 by the National Consensus Project for Quality Palliative Care. The Clinical Practice Guidelines promote quality palliative care, foster consistent and high standards in palliative care, and encourage continuity of care across settings. Since there is shared responsibility for palliative care across health care settings, the emphasis is on collaborative partnerships within and between hospitals, community centers, hospices, and home health agencies to ensure quality, continuity, and access to palliative care. Eight domains of care are discussed and elements of best practices are described: Domain 1: Structure and Processes of Care, Domain 2: Physical Aspects of Care, Domain 3: Psychological and Psychiatric Aspects, Domain 4: Social Aspects of Care, Domain 5: Spiritual, Religious, and Existential Aspects of Care, Domain 6: Cultural Aspects of Care, Domain 7: Care of the Patient at the End of Life, and Domain 8: Ethical and Legal Aspects of Care.
The Clinical Practice Guidelines serve as a manual or blueprint to create new programs and guide developing programs.
Copies may be purchased from the NHPCO Marketplace for $27.00 members and $30.00 non-members.
- 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
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
Palliative Care Resources for NHPCO members