For Profit vs Non Profit

[upwithpeople]

Hello. I am a Registered Nurse who took on another career as a Flight Attendant for 18 years. During this time, I worked occasionally through agency assignments. I was diagnosed with prostate cancer (at age 43) that had metastized to the bone and spine. As a result, I had to take an early disability retirement from the airline, as the treatments and nerve compression from the tumors had affected my performance at work. I am blessed that my airline allowed me to keep my much needed United Healthcare insurance, and with an aggressive round of chemo and radiation, my "hot spots" are actually shrinking at an amazing rate. I did have to go on disability (both SS and a private policy the airline provided). Therefore, my income has decreased dramatically. I am looking to go into Hospice or correctional practice. Fortunately, I have been granted interviews next week at the two largest hospice organizations in my area (Little Rock, Arkansas). One is for-profit......the other non-profit. Would anyone have any input or information on the difference in the operation, quality of care, attitudes, and pay/benefits for a PRN RN for both organizational structures? Also, any advice for my interview. I have been up front with them on my condition, which I actually think might benefit me as I have actually "been there" with an original terminal diagnosis. Any advice from the fine folks here would be greatly appreciated. Lets all take care of each other. Thanks

[sassynurse78]

Although, I have never worked in Hospice, I have worked with them together to take care of many pts. in the long term care facility I work at. I have always admired the group of Hospice workers we have now. They are non-profit. The group we had in for a little while that was for profit was not as efficient. Often they had many different nurses in to see the pt, where the non-profit has the same nurse that always sees the pts. Please do not make your decision based on my opinion, since my experience is way too little. I can add that I have noticed a huge difference in the quaility of the care when compared to for-profit and non-profit. The non-profit seem to keep the pt in mind, while the for profit seems to keep the budget (over budget means a cut in someones bonus ) in mind. Just my 2 cents for what its worth :chuckle Best of luck to you though and glad to hear you are doing better!

[PumpkinsMami]

I have worked for 2 hospices and both are for profit. I don't think that there is a nonprofit left in New Orleans. Anyway, both agencies are very different. The first one I worked for was a corporate company and the bottom line was #1. The second one, which I've worked for 2 years is locally owned and all about pt care. It is nothing for the owners (2 of which are nurses) to be out all night or weekend with a pt who is imminent or needing xtra care. Find out from the community who gives the best care. Go to a LTC facility and ask around on which co gives the best care & who is the most visible. They can be honest with you and have nothing to gain.

[elkpark]

Although I do not have experience with hospices specifically, I have spent the last several years as a surveyor/inspector in acute psych for my state and the Feds. In that role, I visited psych units and hospitals all over my state -- most were public or private not-for-profit, and a few were private for-profit. In my experience, it was v. easy for my teammates and me to tell which were the for-profit facilities/programs -- it was obvious that they squeezed every nickel until it screamed, and cut every corner they could think of to cut. Sometimes the "cost-saving" measures were just funny, and sometimes they were dangerous ... We also tended to receive more complaints about the for-profit programs, and were more likely to find serious problems when we went in to inspect/investigate.

Personally, I'd go hungry or find another line of work before I'd work for a private for-profit outfit.

[doodlemom]

I've worked for both for-profit and not for profit. I would rather work for a non profit. I feel as though my work carries more importance to my superiors as I work for a non profit. When I worked for a for profit, I felt that I was always working for the bottom line - and to line the pockets of big corporate CEO's.

[upwithpeople]

Hello Everyone. I want to thank you all for your information. I have just been hired by a non-profit hospice on a PRN basis, and am very excited. The company has kindly agreed to work around my chemotherapy schedule. Now I again ask a favor......are there any publications or skills I should be brushing up on before my orientation on June 14th? I have already applied for membership in the HPNA.....and have several books concerning transition and after-death patient and family care. Again.....I thank you all so much for your support. Robert

[CardioTrans, BSN, RN]

For information regarding some Medicare guidelines for hospice try the

http://www.cms.gov site. Click on Professionals, then Hospice. There is a wealth of information there.

I work for a home care/hospice company now. We fortunately do both.

Good luck with your new job!

[renerian, BSN, RN]

Glad you got hired! Having volunteered for a non profit for over 10 years/several cities/now changing to one closer to home I loved non profit. I helped with a for profit start up and there is a world of difference. I am not saying for profits don't have good nurses, so please put the guns down, I am saying that if anyone can post here that their for profit hospice has any of the following services (that would be a boon to post here for the company you work for), to help all of us who have been hit by watching bottom lines/no memorial fund to spend on charity cases, and not being able to provide the care nurses want and patients deserve, that would be awesome:

dieticians

aromatherapists

music therapist

art therapist

pet therapist

free donations of supplies not mandated by regs

sharing of the ammounts in the "charity" fund" with the staff nurses so nurses

know how much money is in the "charity fund"

sending staff with their patients out of town so they can have their last wish

to see someone before they die/paying the airfare and the nurse wages for

all the time gone

having a memorial service for patients who have died that has a luncheon for

family to share time with remembered staff

buying air conditioners for a dying person with COPD

buying a furnace for a patient who is dying who has no heat

donating food

I have only seen non-profits do this type of thing

I have seen for profits keep all the charity money as profit and not use a

penny for charity care

Please someone who is working for a for profit post some wonderful things your hospice has done to help someone ...........please.

renerian

[aimeee, BSN, RN]

I have seen for profits keep all the charity money as profit and not use a penny for charity care.

That thought makes me ill.

They also have a reputation for "skimming the cream". They tend to have very high nursing home to home patient ratios because they can promise lots of benefits to nursing homes where the patients are concentrated in one place and the "cost" to carry them is lower. They court the decision makers on the nursing home staff. They are saavy marketers.

[renerian, BSN, RN]

The nursing home statement you made I have also seen before. There is a part of me that feels that is double dipping of the Medicare dollars but that is another thread and I have not put my armour on yet this morning/still drinking my coffee/so I won't start that thread.........

I think it is important to really read the mission, philosophy and drilll down into a company's history first before accepting a job.

JMHO,

renerian

[doodlemom]

I disagree on the "double-dipping". I used to wonder what benefits that hospice had in facilities and since I've been on a nursing home team, I realize that there is not another population that needs hospice more. These people are sometimes all alone and the hospice staff are their only visitors. Facility staff are not trained in symptom management and the patients would be poorly managed without us. BTW, I work for a non profit. The competition for patients has been horrible in the last few years since the for-profits have been in town and I don't think that the patients get as much from them. The facilities do like them because they pay on time and because most of their business revolves around facilities. They are much more efficient at it and their marketing is very saavy.

[renerian, BSN, RN]

I do agree many of the for profits are market savvy and have money they might use from profits to hire sales staff. I still think it is a very sad thing that if I go to a nursing home the staff are not taught to care for me....hmmm I guess the facility should not take people they are not trained for but that is the real world of numbers and bed filling.Now that is the impression from a nursing having been in them working, been in them visiting etc. I guess I have seen the for profits/won't post names, who gee all of a sudden for their facilities, don't do death calls, sorry no volunteers....I have seen it all.

On the double dipping side I have seen lots of contracts, written up some myself between facilities and hospice.....very interesting under the table agreements that might change your mind.

Not all companies are doing these types of things but alot are. Unfortunately the hospice groups will have their head on the chopping block soon.

Thanks for commenting and thanks for caring about the patients. You can see that in your post.

renerian