The Truth About Hospice – Our Response to The Washington Post
By Victor Montour
The Washington Post published an article on December 27, 2014 that may cause confusion for the public who are seeking end of life care. As a leader in end of life care we feel the right thing to do is provide you the truth about hospice and the hospice industry.
A quality hospice is not defined by whether a hospice is non-profit, for-profit or by looking at any single statistic. The tax status of a hospice does not influence the quality of care a hospice provides to patients and families. To learn more about this check out our blog post on September 17, 2014 “For-Profit and Non-Profit Hospices”.
From the time hospice was introduced in America in 1963 by Dame Cicely Saunders the hospice community has evolved over the years keeping patients and families the primary focus. As the need for hospice, the awareness and understanding of hospice services has increased, so has the mix of corporate and non-corporate or for-profit and not-for-profit structures. This structure is reflected in the entire U.S. healthcare sector from hospitals to nursing homes to doctor and dental offices. The hospice sector is no exception to this type of structure.
I ask you to ask the question; what makes hospice so unique then traditional healthcare? The answer; hospice provides care not by a single person but by an interdisciplinary team of specially trained individuals who can address the medical, psycho-social, and spiritual needs of the patient and families served.
Hospice is not about looking at just a disease process, but looking at the whole person and supporting that individual as a whole, along with the family caregivers. Focusing on just the medical care ignores the holistic approach that is the center piece of hospice care. An individualized care plan is created with the patient, family and hospice team for every patient that receives end of life care.
The Medicare hospice benefit is designed as a risk based model of care. It has been this way for the last 40 years. What does this mean? It means that some patients need a larger amount of services and others not as much. The payment at roughly $150 per day (this will vary depending on the county you live in) is spread out to take into account both the more expensive and the less expensive. So a hospice does not make more or less money based on the acuity of the patients they serve.
All hospices regardless of for-profit or not-for-profit must submit to the regulations and standards placed on them by the Centers for Medicare and Medicaid (CMS). The National Hospice and Palliative Care Organization (NHPCO) has been pushing for additional oversight and more frequent surveys of hospice providers to ensure the care you receive from any hospice will be at or above the standards set by CMS. New legislation is now in place that will increase survey frequency beginning in 2015. This will help create greater oversight and increase transparency with the hospice community. The law will mandate surveys of Medicare certified hospice providers at least every three years.
Front Range Hospice has a long standing commitment in strengthening the hospice community. We do this by having quality measures in place to share with the community and our referral sources. Our transparency is key to our success. We establish quality partnerships within the communities we serve to provide our families alternative options for care settings and the ongoing work to improve the delivery of care to patients at end of life.
Millions of families have benefited from hospice care over the years because the hospice community is dedicated to providing the highest quality of care. Data from the Family Evaluation of Hospice Care, a post-death survey sent to families who have had a loved one in hospice care, shows that family satisfaction has remained high and consistent. The survey shows that 93.5% of the 228,000 respondents rated the care the patient received as “excellent” or “very good” and 97.3% of respondents indicated that they would recommend their hospice to others. If you’re interested in seeing the most current post death survey results for Front Range Hospice check our blog post “Hospice Survey – Previously Known As The Hospice Experience Of Care Survey” Posted December 16 2014.
“Focusing solely on the tax status of providers is an affront to every hospice professional working as a nurse, social worker, physician, hospice aide, allied therapist, bereavement or spiritual counselor, volunteer, administrator or other hospice team member. Hospice professionals are dedicated to providing compassionate care, whoever their employer might be. The Washington post article does state “The quality of individual hospices varies widely. In some cases, for-profit hospices provide service at levels comparable to nonprofits, according to the review.”
A number of statements are made in the Washington post article that needs further attention. The best way to do this in this blog is to list the statement from the Post and then provide you, our readers a response to such statements.
The Washington Post States the following;
The Typical for-profit hospice;
- Spends less on nursing per patient.
- Front Range Hospice has one of the best nurse to patient ratios in the state. Our nurses carry smaller case loads so they can spend the time needed with patients and not feel like they are being rushed out the door. Our nurses are available to our patients 24 hours a day 7 days a week. Our Administrators at Front Range Hospice are also available 24 hours a day 7 days a week to assist our patients with any needs, concerns suggestions and after hour admissions. Front Range Hospice has a three tier on call structure staffed with a nurse, a psycho-social member and an administrator. When you call Front Range Hospice after hours and you want to talk to a person, you get a person.
- Is less likely to have sent a nurse to a patient’s home in the last days of life.
- The Front Range Hospice nurses and administration team work hard to provide additional support to our patients and families as death draws near. Front Range Hospice will never keep our nurses from meeting the needs of our patients and families. We will send nursing support out as often as the patient and family is in need.
- Is less likely to provide more intense levels of care for patients undergoing a crisis in their symptoms.
- Front Range Hospice knows and understands the regulations placed upon us to meet the needs of our patients. Front Range Hospice has used and will continue to use the 4 levels of care that are available to patients while in hospice. Front Range Hospice firmly believes our patients have the right to die where they choose. Most wish to die at home. To keep our patients at home Front Range Hospice uses the Continuous Care benefit available to patients in our service when they are undergoing a crisis in symptoms and the patient meets criteria for this benefit. Front Range Hospice also understands that dying is a natural process. Through education with the family and the care givers about the anticipated trajectory of the patient’s disease process and having the appropriate medication at hand, dying is not a crisis and patients are able to remain in their home environment.
- Nursing staff at for-profit hospices had a smaller proportion of registered nurses.
- Front Range Hospice staffs every patient with a registered nurse case manager who is the primary nurse that case manages all aspects of care for our patients.
Again the important message for you is that for-profit and not-for-profit hospice are the same. The hospice professionals and volunteers are dedicated to caring for the 1.56 million dying Americans and their families every year and dedicated to providing compassionate care to the dying. To be with patients and families at such a sacred time is a blessing and we do not enter into it lightly.
The holistic care that is delivered at the bedside in every corner of our nation is guided by the hospice philosophy of care developed in 1963. Front Range Hospice is committed to educating the communities we serve and the public at large about the truth in hospice.
If you would like more information about Front Range Hospice call 303-957-3101 or 970-776-8080 or email us at firstname.lastname@example.org
Watch out for our next blog: Do you know the 4 Levels of Hospice Care?