Working with a University Medical Center

Hospice of Central Ohio in Newark is now working on a leased bed agreement with Wexner Medical Center at Ohio State University to open a 12-bed hospice unit inside the hospital. Minor revisions and resurfacing are underway to give the new hospice unit more of a homelike feel in its health facility setting, with opening planned for a few months from now.

“This is part of the hospital’s strategy for how to manage its seriously ill patients,” says the hospice’s President and CEO, Kerry Hamilton. “My conversations with OSU about hospice started 18 years ago, but something on their side changed recently. They’ve always acknowledged the value of hospice care, but new imperatives have driven them to consider new strategic approaches. If you are at OSU Wexner Medical Center and are dying and in need of hospice care, right now they have to send you someplace else. This collaboration will help to address that issue.”

Some of the imperatives putting pressures on academic medical centers include new payment models with a focus on bundled payment, coverage of populations, prevention of hospital readmissions and the like, Hamilton explains. “I believe it’s a big shift and OSU is one of the academic centers leading the charge. They put out a request for information tied to a plan for a demonstration in their system, but that concept was not tenable at that time.” OSU then looked at opening its own hospice unit, but for a myriad of reasons decided to contract with Hospice of Central Ohio, instead.

“We have identified that the anticipated complexity of these patients means higher staffing levels on our hospice unit, using RNs and advanced practice nurses and drawing upon social services from the hospital. These will be the most complex, difficult and medically involved patients of any partner that we work with,” he adds, involving for example left ventricular assistive devices, ventilators, total parenteral nutrition, and other assorted drips.

”At least in the beginning, length of stay will be very short as we work to evolve the culture in the hospital to allow for earlier referrals to hospice care based on trust and collaboration.” In the beginning most of the patients will be eligible for a general inpatient level of hospice care and will likely be billed at that level. The hospice is also building an endowment for uncompensated care on the unit and is in conversation with the medical center about some form of cost sharing for these complex hospice patients.