how to choose hospice why ownership

Tuesday, March 08, 2005

How to choose a hospice: Why ownership matters

As I said in the previous post, the differences between hospice companies are often small and usually very hard to find. This post deals with one thing that I feel is a huge difference; Ownership.

When you pick up the phone and call a hospice ask to speak to the Administrator. I say this because the Administrator is probably the person in charge. If you talk to the Office Manager and successfully get some commitments over the phone you will always risk having the Administrator come back later and say that the Office Manager should have never told you that they would do _____. Tell them that you are thinking about signing yourself or your loved one up on hospice, and that you want to ask the Administrator some questions. Any promise you get from the Administrator will not be overruled later by the bean counters. The Administrator is the bean counter or is the boss of the bean counters. If the Administrator won’t talk to you, then the hospice is probably too big. (Well talk about that in a later post.)

I’ve digressed. Now, back to ownership. Who owns the hospice is a very important question, because it gets to the very core of the reason the company exists. Here’s my rant. If a company is listed on some stock exchange, then the stockholders are the owners. Do you think they invested in the company because they wanted to own the stock of a company that takes goof care of people? Do you think Charles Schwab advises their clients to invest in HCR Manor Care (the owner of the national chain Heartland Hospice) because they treat people right? No, investors buy stock because the company turns a good profit. If the owners of the company are focused on profit, then those that run the company must make money or else. In that situation, patient care can not be the number one priority. If you and the owner of the company have different goals, then there is always the potential for problems. Avoid the problem by finding out who the owner is and what their background is.

That’s question number one. I’ll post on question number two later.

A special note for those of you choosing a hospice for someone in a nursing home: Do not use a hospice that is owned by the nursing home. Let me repeat. Do not use a hospice that is owned by the nursing home. Odds are the nursing home has told you that you should consider hospice and in the same breath told you that you should consider a specific hospice. If the hospice they recommend is owned by the nursing home or by the same person who owns the nursing home, stay away! I can not stress this enough. The biggest service a hospice provides for nursing home residents is a different set of eyes and ears for the patient. A hospice that is not affiliated with your nursing home will not have any problem reporting a problem if they see one. Their focus is making sure that the patient is cared for, and if they have to piss someone at the nursing home off to get that job done, then so be it. If the hospice and nursing home are in bed together, then the hospice employee knows that they risk losing their job buy causing a stir when problems arise. Worse than that, many nursing home/hospice combo companies have a large amount of crossover employees. If the nursing home nurse changes her nametag during the day and becomes the hospice nurse, do you really think she will do much in the way of assessing the patient? She saw the patient earlier in the day as his/her nursing home nurse, so why pay attention later just because she has a different name tag on? One more time: do not use a hospice that has the same owner as the nursing home. Every nursing home patient needs someone who is willing to rock the boat. Hospice workers are professional boat rockers; don’t reduce the impact that hospice can have on your loved one by using a hospice that can’t speak freely when there is a problem.

Follow the link to read part three of the series: Why management matters

UPDATE: This post on companies who offer both Home Health and Hospice may be helpful to you if you are considering a company that offers both services.