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2011 Hospice Survey
IAHHC: 2011 Hospice Survey
The Indiana Association for Home & Hospice Care (IAHHC) is the voice for hospice providers. Please help us out by taking this short survey so that we can make sure we're best meeting your needs. Thank you.
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1
. IAHHC publishes the Hospice newsletter monthly as a down-loadable file within the Communique. How would you like to receive the Hospice newsletter in the future?
IAHHC publishes the Hospice newsletter monthly as a down-loadable file within the Communique. How would you like to receive the Hospice newsletter in the future?
I'd like to receive the Hospice newsletter directly to my email.
I'd like to access the Hospice newsletter through the Communique.
2
. Do you have an inpatient unit?
Do you have an inpatient unit?
Yes
No
3
. If you do have an inpatient unit, is it:
If you do have an inpatient unit, is it:
Freestanding
Part of Hospital
Part of SNF/NF
Other (please specify)
4
. What levels of care does your inpatient unit provide?
What levels of care does your inpatient unit provide?
GIP/Respite Only
GIP/Respite/RHC
RHC (residential) only
5
. Do You Lease Beds?
Do You Lease Beds?
Yes
No
6
. If you do lease beds, how many do you lease?
If you do lease beds, how many do you lease?
7
. Do you have a defined, separate program for pediatric hospice patients?
Do you have a defined, separate program for pediatric hospice patients?
Yes
No
8
. If you do have a defined program for pediatric hospice patients, please describe the type of services and patient eligibility criteria.
If you do have a defined program for pediatric hospice patients, please describe the type of services and patient eligibility criteria.
9
. Do you offer palliative care services?
Do you offer palliative care services?
Yes
No
10
. If you offer offer palliative care services, what type of services (e.g. physician consult, nurse practitioner, social worker, bereavement, etc.) do you offer?
If you offer offer palliative care services, what type of services (e.g. physician consult, nurse practitioner, social worker, bereavement, etc.) do you offer?
11
. Do you bill for palliative care services?
Do you bill for palliative care services?
Yes
No
12
. Where are services provided?
Where are services provided?
Hospital only
Hospital and community
Nursing facilities
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