Viability for the Hospice House Model

We recently caught up with hospice consultant Sue Lyn Schramm, who led a preconference session on hospice facilities at the National Hospice and Palliative Care Organization Management and Leadership Conference in April and a similar one last year, described here, which explored the precipitous drop in utilization percentages for hospice general inpatient (GIP) care that has left many hospices with facilities scrambling to keep beds full.

“All of the challenges we talked about a year ago still apply,” Schramm said in summarizing this year’s NHPCO precon. “GIP days are lower, patients are more acute, and balancing the bottom line is difficult.” But the tone of the meeting was hopeful, she added. “There are lots of things people can do to manage their units, and I hope I gave them practical tips to use. Answers vary widely depending on your own unique local circumstances. I did not have a sense that it was a funeral for the Hospice House model. We’re in a very interesting time given the demographic trends. Demand for inpatient and residential hospice care can only go up.”

Schramm says some of her clients have waiting lists for their hospice facilities while others are looking to build or expand for competitive reasons or because their hospitals are asking for it. But the terminology is another challenge for the field. “Is Hospice House or home too warm and fuzzy a name to describe the actual experience of caring for acutely ill hospice patients referred for GIP (and qualifying for GIP-level coverage)? I think Hospice Houses can sell themselves short.”

But what is the right terminology for a hospice organization trying to provide residential-level care or a mix of residential and GIP? What do you think? (Read more about what Schramm has to say here.)

Larry Beresford, Editor & Publisher

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