Funding hospice care: donations make a difference

Editor’s Note: The following article is a continuation of a series of articles celebrating November as National Home Care and Hospice Month.

As an entity of Lincoln County Health System, Lincoln Medical Home Health and Hospice is a nonprofit home health and hospice provider.

“Although we share one name, we are two distinct agencies, providing both Home Health and Hospice services to the residents of Lincoln County and surrounding areas,” said Susie Compton, administrator of the agency.

“For patients in our hospice program, end of life care and support is furnished by a dedicated team of professionals. Together with the other affiliates of the Health System, including Lincoln Medical Center, Lincoln and Donalson Care Centers, Donalson Skilled Nursing Facility, Donalson Assisted Living and Patrick Rehab, we are able to provide a continuum of care, literally from birth to death.

“As a hospice, we are reimbursed for care provided to the terminally ill by Medicare, Medicaid, or private insurance,” explained Compton. “Hospices are not reimbursed on a fee for service basis. Rather, hospices are paid on a per diem basis, which means that reimbursement is a set fee based on how many days the patient is enrolled in the program and the level of care provided.”

In return for payment, Medicare, Medicaid and private insurance companies expect a hospice to provide all services that the patient and family need that are related to the terminal illness. The Centers for Medicare Services (CMS) regulations mandate that the hospice program is in compliance with these regulations.

“What this means,” Compton elaborated, “is that regardless of the number of clinical visits that are needed, the amount and kinds of medications provided, or the supplies and equipment that a hospice patient requires, Medicare pays one flat daily fee. The total cost of care for some patients will be slightly less than what is paid by Medicare. The cost of care for other patients will greatly exceed what the agency will be paid by Medicare or other insurance providers. Our hospice strives to make sure that each patient and his or her family’s individual needs are met, regardless of the expense.”

For-profit hospices have no obligation to provide services to anyone who does not have coverage from Medicare, Medicaid or private insurance. They can refuse to provide services if they cannot ascertain payment.

“Nonprofit charitable hospices, like Lincoln Medical Hospice, provide hospice services to those persons within their jurisdiction who do not have coverage and cannot afford to pay for care,” said Debbie Kilpatrick, social worker, bereavement and volunteer coordinator for hospice. “This is a great service to our community, but the costs can be extremely high”.

She adds, “The Medicare Hospice benefit also includes bereavement and grief support for the patients’ caregivers. An assessment of the family’s bereavement concerns and needs begins on admission. For a full year after a patient’s death, the family and caregivers are offered bereavement support. This service is not billable for the hospice and is provided free of charge to all patient families. It is a wonderful extension of the hospice program, but it does cost the hospice money to provide it.”

Compton stated, “As per Medicare regulation, the cost of hospice care is partially offset by the use of trained volunteers who can assist with caregiver relief, bereavement visits and mailings, and office tasks. We are fortunate to have a wonderful group of volunteers. Careful management of medications, supplies, and man-hours is also a must, especially as Medicare reimbursements decrease. Even with careful resource management, expenses are incurred that must be absorbed by hospice. For this reason, donations to a hospice can provide invaluable financial support.”

“After the death of their loved one, some families suggest making memorial donations to the hospice they used in lieu of flowers. This is a very significant source of funds to the hospice and helps to cover expenses incurred in running the hospice,” said Kilpatrick.

“Other suggestions for giving include making an annual donation in memory of a loved one on their birthday or other anniversary. Individuals who work for an employer who participates in the United Way Workplace Campaign can name Lincoln Medical Home Health and Hospice as the non-profit organization to support with their regular donations. Civic organizations and our own Lincoln Medical Center Auxiliary volunteers have held fundraisers over the years to raise money that they have donated to our hospice to support our work. We also receive random donations in the mail that are welcome surprises. And, of course, all donations are tax deductible.”

“Sometimes I am asked if a donation can be made so that it is used exclusively for one patient, or one purpose,” said Compton. “This can be done, but it is far more beneficial to allow a hospice to use cumulative donations to offset overall costs, or to be able to meet those unforeseen expenses that can occur during the course of treatment.” 

Kilpatrick added, “We’ve been able to use donations to purchase a number of items for families in need. Most importantly, we can provide care for patients who are sick and in desperate need of care, with no insurance and nowhere to turn.”

To learn more about the hospice program and to discover more ways to donate to Hospice, visit the Lincoln County Health System website and click on Hospice Care at http://www.lchealthsystem.com/lchs.nsf/View/homehealthhospice.

Posted on Monday, November 19, 2012 at 10:50 am