I think Hospice needs hospice...

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Specializes in med/surg, hospice.

What do you think? Nurses that have been in hospice for longer that I have been all say the same thing...that it is so radically different than it used to be (not for the good) and there is no sign of recovery in sight. :o

For our other experienced folks....what do you see? And do you see anything that can be done about it?

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Specializes in critical care; community health; psych.

It does seem to be a self perpetuating end unto itself a great deal of the time with the bottom line the almighty dollar.

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Medicare can change things around quickly by tightening up the regulations and/or enforcing them; many believe this will happen within the next few years. Sad to see more government regulation, but greed

has disparaged an otherwise noble profession.

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I have been doing this for 4 years but yes, I definitely see big changes. The politics are becoming unbearable - big push to sign more people up, find reasons to put them on Continuous Care, go canvass for new patients. The paperwork is becoming burdensome at best, and it's only getting worse. I'm not in marketing, I'm a nurse. And that's what I want to do. I'm at the point where I feel my values are starting to be compromised. And it makes me sad, because I love my work with patients. It's everything else that's getting to me....

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Specializes in Hospice, Palliative Care, OB/GYN, Peds,.

I guess that I am fortunate to work for a non profit Hospice that has not subscribed to the almighty dollar idea. However there have been at least 5 new Hospices which are for profit move into our area and I am amazed at the tactics they use to get patients. One recently held a gala for the physicians , wow, we don't have that kind of money to do for the docs. We would rather spend it on patients. We have a telethon tonight to raise money for our patients so we can pay light bills, debug homes or buy heaters or a/cs. We carefully screen patients before admission to ensure they meet LMRPs since Medicare has been in the denial frame recently. What do your leaders expect as far as getting patients for them?

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I guess that I am fortunate to work for a non profit Hospice that has not subscribed to the almighty dollar idea. However there have been at least 5 new Hospices which are for profit move into our area and I am amazed at the tactics they use to get patients. One recently held a gala for the physicians , wow, we don't have that kind of money to do for the docs. We would rather spend it on patients. We have a telethon tonight to raise money for our patients so we can pay light bills, debug homes or buy heaters or a/cs. We carefully screen patients before admission to ensure they meet LMRPs since Medicare has been in the denial frame recently. What do your leaders expect as far as getting patients for them?

FYI - we're non profit, too! Our leaders have told us that, starting next year, our reviews (read salary increases!) will be based on goals. OK - that's good BUT one of the goals is going to be how many people we bring onto the program!!! I still can't believe it, and that I'm expected to be party to it...

Has this happened to anyone else??? Or am i just being stubborn??

:o

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Specializes in critical care; community health; psych.

I don't think a lot of people know this, maybe they do... just throwing this out there. Not for profit doesn't mean they're not making money. It just means that they know how to make it look like something else on paper. UPMC, Western PA's leading industry, is not for profit and they made $600 million last year. Not too shabby for a corporation that enjoys a tax exempt status. It would curl your hair to know what the execs make as a salary.

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Thats for sure rnkittykat! Just wanted to add that homecare is not like it used to be either. Dirty politics, stealing patients from other agencies,some of the most back stabbing marketers you will ever meet, not to mention that physicians maybe getting kick backs to give agencies their patients.

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Specializes in med/surg, hospice.
I don't think a lot of people know this, maybe they do... just throwing this out there. Not for profit doesn't mean they're not making money. It just means that they know how to make it look like something else on paper. UPMC, Western PA's leading industry, is not for profit and they made $600 million last year. Not too shabby for a corporation that enjoys a tax exempt status. It would curl your hair to know what the execs make as a salary.

My experience has been that "not-for-profit" is a ruse at best and an outright lie at worst.

Now...I really don't want to just bring up problems without coming up with solutions as well. We are patient advocates. I have been appalled by things I have seen in ALL hospices. There is one large hospice here ("not for profit" BTW) that pays nursing homes a premium above the room and board reimbursement. Plus they "eat" all pharm expenses, send CNA's five days a week and provide diapers, wipes, chux pads and all needed DME. :o Tis ggrrrrrooooo$$$$$$ Tis all about the munnay. and....of the two hospices that I have worked for, they are much more concerned that all of the paperwork is right (read: perfect) than they are that pt care is done right. This is of course so they can bill without any losses. Now, I know that a business exists to make money but my I am covering for the current hidden culture in hospice by bending over backwards to meet the needs of my patient.

*whew* sorry folks....but I feel better now...

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Specializes in Med/surg. Some critical care, geriatrics.

I am new to Hospice and really love it. My expierience has been with for profit and non-profit places. The particular hospices I did and currently work for, the for profit did not take care of it's employees. low pay, terrible insurance and minimal staff. Mileage was horrific! ANd I put 6000 miles on a new vehicle in a few short months! The non-profit I work for now really takes care of it's employees and we have resources:typing. I think it depends upon the community you live in, too. Here the majority, including the medical community, backs the non-profit over the for profit ones. THe pay isn't much better, but mileage is, call is, and having LVN's and HHA's, plus medical records, onsite social worker,on site vol. coordinator, on-site chaplain helps tremendously. THe for profit I worked for didn't have those things. And our supervisor was over 2 offices, an hour apart!! SO you have to weigh the differences and understand how things are worked. THe real difference is that nonprofit do not pay taxes. They are under the same rules and p&p that for profit must follow. THis one does a great job and I am proud to work there.

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Specializes in Med/surg. Some critical care, geriatrics.

It is also a great privelage to care for these people that are in the last days of their lives. And I feel as a Christian, it is easier to do your job and understand God's true plan for how he wants us to die, so we can be with him. I am glad we have a blessing of Hospice to help us help others.

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