Is hospice on the down swing?

QuiltDog · Mar 22, 2015

We have been fluctuating up and down for several years. I think hospice, like all of health care, tends to be cyclic. That said, I think we will continue to see smaller hospices opening and then closing if they cannot compete and keep up with CMS regs. I don't know what the future holds, but death is not going away and I see smart hospices adapting to the needs of patients, families, and facilities.

heron, ASN, RN · Mar 22, 2015

Part of the "boom" was the artificial inflation of census by way of inappropriate admissions, levels of care and re-certifications. Because of the flat-rate reimbursements by CMS under the hospice benefit, head-count = profit margin. As CMS closes loopholes, inappropriate admissions/recerts get harder = lower census.

Hospice, like home care, has been a cash cow for years and now the boom times are going bust.

The same pattern has been repeated since the beginning of third-party payments and especially since the advent of Medicare. It's the nature of our economy.

toomuchbaloney · Mar 22, 2015

I am pretty sure that at least 7 in 10 Americans say that they would rather die in their own homes than they would prefer to die in a facility or hospital. Yet, most die in a facility or hospital. This suggests to me that there remains a large population of citizens who are not receiving the option of hospice care in their last months.

Nash3222 · Mar 22, 2015

All are valid points, if more people understood what hospice is all about, they would use the service. But the uninformed think along the lines of hospice : " stops all meds, does not feed them, over medicates them, then they die".

We really do provide a much needed service.

Nash3222 · Mar 22, 2015

heron, I see your in Albuquerque, that is exactly where I want to move to. Love NM and that area, currently in the mid west. Long story short have been getting things in order to move this summer.

Would love to talk to you for any advise about living there, Hospice work , etc.

I can send you my private email if your interested.

thanks

CapeCodMermaid, RN · Mar 23, 2015

Hospice does not provide 24 hour care. Many people are far too sick for their families to be able to care for them at home. If you are an elder on Hospice, your spouse is most likely an elder too who would be unable to turn and reposition you or change your sheets...

The number of people on Hospice in long term care facilities is on the rise so I think good Hospice providers will be around a long time.

PS I'm one of the 3 in 10 who does NOT want to die at home.....it would always be "the room Mom died in".

heron, ASN, RN · Mar 23, 2015

@Nash322: happy to help - PM me.

OneDuckyRN · Mar 23, 2015

PS I'm one of the 3 in 10 who does NOT want to die at home.....it would always be "the room Mom died in".

This. I wouldn't want to die at home (my own or somebody else's) either because of the memories it could evoke. I'm praying my parents and sister feel the same way when it comes time to make that decision. I'd rather go to an inpatient hospice facility or LTC with hospice.

toomuchbaloney · Mar 23, 2015

I think we have some odd notions about death in America today.

I wonder why the memory of a dignified death in the family home would some how taint an entire lifetime of good memories in the same home?

ktwlpn, LPN · Mar 23, 2015

Lying in bed and staring up at the same ceiling in the bedroom where both of my parents died was too much for me.That house represented both of their long illnesses and deaths more then any "good times" It has taken me many years to block that last vision of my mom lying in that room dying....Had to get out of there.....Forget about a sex life,too.....

CapeCodMermaid, RN · Mar 23, 2015

It's a matter of personal choice. We should all be able to decide where, and if I might, add HOW we decide to die.