Some providers of hospice care are giving the movement a bad name.
That’s a sad development, because the hospice movement originally started by religious and community organizations has helped many spend their final days with a better quality of life.
The danger is that the for-profit companies that are gaming the system will damage the image of hospice, and worse, make some people reluctant to enter hospice care.
Hospice care is intended for people who are terminally ill, and the goal is to manage a patient’s pain, and care for the patient’s emotional and spiritual needs. Some patients thoughtfully choose hospice care rather than taking extreme measures that at best might extend life for a few weeks.
A front-page story in the Dec. 30 Journal Star reported that hospice has evolved into a $17 billion-a-year industry. About $15 billion of that revenue came from Medicare.
Based on statistics, some people are being placed in hospice who don’t belong there, even though two doctors are supposed to certify that the patient has a life expectancy of six months or less.
Admittedly, that can be a judgment call. But the rising percentage of people who leave hospice care alive raises questions. In some for-profit branches, as many as 78 percent of hospice patients left alive.
By comparison, in the local Tabitha Hospice program, only 12 percent of hospice patients were discharged alive, Tabitha President Christie Hinrichs wrote in a Jan. 3 Local View column.
In a letter to the editor, Heath Boddy, president and CEO, and Gary George, board member of the Nebraska Hospice and Palliative Care Association, wrote that Nebraska’s “homespun values” make the state different. In Nebraska the average hospice stay is only 57 days.
Yet fraud occurs. In 2012 Hospice Care of Kansas LLC and its parent company, Voyager Hospice of Texas, paid a $6.1 million settlement for allegedly enrolling nonterminal patients. Last year the Justice Department charged Vitas Hospice Services and its parent company Chemed Corp. of Cincinnati with collecting “tens of millions of taxpayer dollars” in fraudulent hospice claims.
In a letter to the editor hospice nurse Pat Meierhenry of Lincoln wrote that as a nurse she learned that “whenever a third party pays for something, someone figures out a way to make money for it.”
She’s right. In order for the hospice movement to continue its good work, whistle-blowers and the government need to continue to work on weeding on the people who are using hospice to make a dishonest buck. In the end, the enforcers are protecting hospice and its proper role.