By Jeff Alexander, Director of Business Development
Avow Hospice, Inc.
In my work every day, I hear stories of panicked and scared family members trying to decide which hospice to choose for their terminally ill loved one. For most families, the decision to admit a sick person for end-of-life care comes after months, and sometimes years, of fighting a challenging illness and managing its devastating effects on everyone in the patient’s orbit. Turning a loved one over to a hospice is an act of trust. Fortunately, there are ways for you to assess which hospice to choose when the time comes, so you are confident you have done all you could for the sick person you love.
The most important question we suggest you ask each potential hospice provider is whether it is a nonprofit (NFP) community organization or a for-profit (FP) corporation. The answer will likely give you insights into the personality, values, mission and vision of the hospices you’re considering. It will also lead you to objective, third-party analyses of how quality of care measures consistently show that nonprofit hospices provide better care.
As you look for the hospice that’s right for your family, let’s review some things you don’t have to worry about.
• All hospices that accept Medicare/Medicaid (virtually all of them) provide the same required core services, such as care by nurses and home health aides.
• All hospices must follow the same state and federal regulations.
• Medicare pays all hospices the same daily rate, regardless of diagnosis.
So, what makes nonprofit hospices different, if they share so many characteristics with for-profit hospices?
• A recent study* shows that nonprofit hospices provided patients with 10% more nursing visits, 35% more social worker visits, and twice as many therapy visits as for-profit hospices, per patient day. Patients in nonprofit hospices received almost three times as many visits from a hospice physician or nurse practitioner (1.49 vs. 0.51 visits per 100 patient days) than for-profit hospice patients.
• Nonprofit hospices welcome everyone – regardless of diagnosis, ability to pay, or their potential to be “lucrative” patients. Ask which diagnoses are the most common at the hospices you’re considering. You are likely to see that for-profit hospices care for more patients with degenerative diseases than other diagnoses because those patients need less care and stay in the program longer, thus generating more revenue. Nonprofits welcome all.
• Because nonprofit hospices have no need to pay dividends to shareholders, they use donations and reserves to:
– Offer additional services to patients and the community, for which they are not paid.
Examples are music therapy, massage therapy, and art therapy for patients and multifaceted bereavement programs for children and adults, open to all without cost.
– Invest in ongoing training and development for patient care team members, and to hire more advanced practice registered nurses and therapists to the team.
– Reinvest in their communities through partnering with other organizations, hiring locally and building within the communities that support their mission.
Ask each hospice you’re considering to describe the “extra” services they offer beyond what’s required. Can they show you how they invest in staff training? Will they share a list of community partners whose work they help advance?
• Nonprofit hospices are governed by a volunteer board of directors who represent the demographics and unique needs of their communities. Such boards guide the development of their hospices based on what their communities need to navigate difficult transitions such as illness, death, and loss. They may, for example, vote to invest in money-losing programs because they know people desperately need those services, and that it is the hospice’s mission to provide them.
Selecting the right hospice for your family is a big responsibility that usually comes at a time of great stress and urgency. Fortunately, in addition to considering the points in this article, you can review these additional objective measures of a hospice’s quality:
• Accreditation by a third party, such as The Joint Commission. Accreditation isn’t required, but it does show a hospice’s commitment to excellence and going beyond minimum requirements.
• Family satisfaction scores from former patient families, showing how hospices compare in a head-to-head matchup on various quality indicators. This Medicare tool is available at https://www.medicare.gov/care-compare/
Please accept my personal invitation to talk about finding the perfect hospice for your family. My team in the Avow Patient Access Center welcomes your toughest questions about why Avow may be the right fit for you. We are Collier County’s original nonprofit hospice, formed in 1983, and we remain the only nonprofit hospice ready to care for you. We are proud of our 21 continuous years of quality accreditation by The Joint Commission and our satisfaction scores from former patient families. To reach us 24/7/365, call us 239-280-2288.
* “Hospice Medicare Margins: Analysis of Patient and Hospice Characteristics, Utilization, and Cost”, July 2019, Commissioned by the National Partnership for Hospice Innovation. Bazell, Caplen, Coates, Pelizzari, and Pyenson.
Avow Patient Access Center
239.280.2288
www.avowcares.org