Op-Ed by Sue Ranson
Readers may have been concerned by a Washington Post report picked up in The Roanoke Times (“Number of ‘Hospice Survivors’ Increasing Sharply,” Dec. 28). I wanted to offer a local perspective because the article is clearly not representative of all hospices.
The major theme of the article is that hospices are admitting patients who are not dying because they are “more profitable,” living longer and requiring fewer hospice services. The article cites some statistics that do not reflect the local reality. The writer states that at one hospice, 78 percent of their patients “left the hospice’s care alive.” The article goes on to assert that Medicare “has created a financial incentive for hospice companies to find patients well before death.”
This incomplete picture is not reflected in the Roanoke and New River valleys. For 22 years, Good Samaritan Hospice has been serving our communities as the only stand-alone, non-profit, community-based hospice. When assessing new patients for care, our staff does not have a “quota” to fill. We carefully follow Medicare’s guidelines regarding eligibility, using objective measurements of patient functioning. Both our medical director and the patient’s attending physician certify that a patient is eligible for hospice care under those guidelines.
Conversely, our concern is not about longer lengths of stay and inappropriate admissions. Families tell us they feel their loved ones were referred to hospice too late. Consider our local data:
- Our average length of stay in 2013 was 58 days.
- 24 percent of our patients are under our care seven days or less.
- Just 7 percent of our patients are under our care for six months or longer.
- We “graduate” approximately 13 percent of our patients, a very reasonable percentage that speaks to the fact that some of our patients improve under our care.
- Almost 20 percent of the families who respond to a survey we send after a patient dies state that they wish their loved-one had hospice care sooner.
The article also left an important element out of the discussion – the patients and families being served.
For example, the writers do not address any statistics on patients who aren’t seeking the highest level of care because they have been given a terminal diagnosis – and are therefore saving money for Medicare. In fact, hospice care represents only 2 percent of Medicare spending and palliative and hospice care is cheaper in the long run than advanced medical treatment to keep a patient alive, according to the National Hospice and Palliative Care Association.
The writers also failed to address the challenges hospices face in admitting patients early enough to have a positive impact in their quality of life. The goal of hospice care is not to ensure that patients die in a specified time. Hospice is designed for patients to receive compassionate care at a critical point in their lives.
At Good Sam, our mission is focused on the care and comfort of hospice patients and their loved ones – not a corporate bottom line.
If we take away one message from this article, it ought to be that patients and families should not hesitate talking about their end-of-life wishes and when appropriate, in conjunction with a medical team, seek the high quality and compassionate end-of-life care that hospice delivers every day.
Sue Ranson is president and CEO of Good Samaritan Hospice, a non-profit hospice serving the Roanoke and New River valleys.
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