A new online consumer guide to hospice published by The Washington Post aims to address what it says is a lack of Medicare data that is easily accessible for consumers.
The Washington Post gathered data largely from government sources on more than 3,000 hospices that participate in Medicare, which pays for the vast majority of hospice care in this country.
“No single factor can predict the quality of a hospice’s care, and these figures do not offer a complete picture of any single hospice,” The Washington Post says. “But consumers can benefit from knowing how a hospice compares to others on these important measures.”
The guide was announced in The Washington Post’s fifth installment of its “Business of Dying” series, which charges that there is an “absence of public information about [hospices’] quality, a void that is unusual even within the health-care industry, [which] leaves consumers at a loss to distinguish the good from the bad.”
Eighteen percent of hospices do not provide continuous nursing care or inpatient care for patients in crisis, data show. And a similar proportion regularly fail to have a registered nurse visit the patient in the 48 hours before death; and at hundreds of hospices, more than a third of patients drop hospice services before death — “a sign that the patients may not have been getting adequate care,” The Washington Post says.
The reasons that some hospices stint on care may be at least partly financial. Medicare, the chief source of industry revenue, pays hospice companies per day of care — about $155 for a “routine” day — regardless of how much care is actually provided. That means that the less a hospice spends on nursing and other services, the more it can profit.
Janice Holan, whose husband, a lung cancer patient, died at home under the care of a Pittsburgh-area hospice, tells The Washington Post that her husband received poor care despite their doctor’s recommendation for the agency Horizons Hospice.
The hospice allegedly failed to provide the medications her husband needed, leading to his cause of death. A lawsuit is now pending.
“It was horrible,” Janice Holan tells The Washington Post. “My husband was suffering. There was nobody here.”
The database shows whether the hospice has provided more intense levels of care for patients suffering a crisis; how much it spends on nursing visits per patient; whether it has won approval from one of three outside accrediting agencies, the Joint Commission, the Accreditation Commission for Health Care and Community Health Accreditation Program, or CHAP; and other factors.
Written by Cassandra Dowell