Take Me To Post Comment Form The "Hospice industry, unfortunately, has fallen from grace with the Center for Medicare and Medicaid Services (CMS). According to the president of the National Hospice and Palliative Care Organization (NHPCO), at least three of the top representatives of CMS recounted personal experiences of poor care by hospice organizations. Officials at (NHPCO) actually validated these specific incidents. I was at a meeting in Charlotte, North Carolina recently and heard the President of NHPCO discussing the nation wide proliferation of new hospice providers, the increasing numbers of Americans choosing hospice care and the subsequent increasing occurrences of “errors in judgment".

NHPCO is working with CMS to develop valid strategies for hospice providers to demonstrate Standards of Care and to make evident that their services merit their reimbursement. And while the ropes of tighter regulation are being tied, several new for-profit hospice providers in our service area are buzzing all around, soliciting doctors and other health care agencies for the names of their “terminally ill patients. Whether substandard care, (coupled with unethical marketing practices) is a result of administrative ignorance, carelessness or greed, makes no difference. It causes harm and, in the long run, causes barriers to the excellent end-of-life care that is available.

I am no longer being polite about it. It is the case that Hospices are hiring marketers who must meet specified monthly quotas: referrals of dying patients! It is therefore no wonder that I am hearing first hand accounts of stories, that only a few years ago, I would not have imagined were true. A relative of one of our nurses was approached in a fast food restaurant by a representative of a “hospice". Her elderly relative was wearing oxygen. The young man handed her his business card and asked her to call him. “We can help you at home, he said. Another friend of a colleague was actually followed from a dialysis unit back to her nursing home by a black car with “This & That Hospice" name and logo plastered on the side door. This hospice marketing representative followed her into the room. The family was outraged! I recently was at our local hospital for a meeting and saw a shiny yellow car with large letters of “So and So Hospice" visible on each side. These cars have even been spotted in the driveways of patient's homes who, I’m certain, are too ill to recite the federal HIPAA laws, protecting patient privacy! These cars remind me of my childhood days when the ice cream truck visited my neighborhood, soliciting their goods to children. The more colorful the truck, with the largest letters and loudest bells sold the most ice cream. Sadly, we recently cared for a man who came to us near death with long standing, intractable pain. He had signed up with a “hospice" several weeks prior. With excellent symptom management achieved in collaboration with his physician, our medical director and our staff, he died peacefully.

Am I mad? You’re darn right I am. Hospice care should be an honorable service. It should be coordinated and performed with great respect, dignity and skill. Hospice care should be designed carefully with the provision of privacy and compassion. This requires many hours of thought, planning and hard work by staff, administration and a skilled board. We are not selling ice cream and those who are at life’s end are not commodities.