An Explanation of Palliative Care

NHPCO’s Standards of Practice for Hospice Programs  describes palliative care as:

Treatment that enhances comfort and improves the quality of an individual’s life during the last phase of life. No specific therapy is excluded from consideration. The test of palliative care lies in the agreement between the individual, physician(s), primary caregiver, and the hospice team that the expected outcome is relief from distressing symptoms, the easing of pain, and/or enhancing the quality of life. The decision to intervene with active palliative care is based on an ability to meet stated goals rather than affect the underlying disease. An individual’s needs must continue to be assessed and all treatment options explored and evaluated in the context of the individual’s values and symptoms. The individual’s choices and decisions regarding care are paramount and must be followed.

Current News

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

Additional Resources

• Questions and Answers
• Messages
• Physician Board Certification in Hospice and Palliative Medicine - information provided by ABHPM