Below are thoughts from the President and CEO of VNA Community Healthcare & Hospice, Janine Fay.
The phrase may be that one bad apple can spoil the whole barrel, but one bad apple – or even a few – doesn’t illustrate the integrity of the rest of the apples on the tree.
On Tuesday, July 31, NPR was the first to cover a federal report from the U.S. Department of Health and Human services Office of the Inspector General regarding the Medicare Hospice Program. NPR’s broadcast and article were headlined “Fraud and Neglect Are Problems In Hospice Industry, Federal Report Finds” and detailed the findings culled from patient and Medicare payment data over the past 13 years.
The federal report states that there are hospices that do not always provide needed services to beneficiaries and sometimes provide poor quality care. It also states that there have been instances in which hospices overbill or, in extreme cases, commit fraud by enrolling beneficiaries who are not eligible for hospice care or by billing for services never rendered, thereby costing Medicare hundreds of millions of dollars.
This is troubling to the general population, but perhaps even more so for dedicated nonprofit hospice providers like VNA Community Healthcare & Hospice that do not want their reputation at risk when the criticisms of hospice were not, in their case, earned.
These findings are critical to shed light on hospices lacking in quality of care or seeking to defraud the system, but the release of this information paints hospices with a broad brush and can be damaging to the hospice industry and the many providers who seek to serve the best interests of patients and their families above all else.
Hospice focuses on quality of life and provides physical, emotional and spiritual support to those faced with a life-limiting illness. The majority of hospice services nationwide is provided in the home and includes bereavement care for family members for more than a year after a loved one has passed away.
The fact that the OIG report found many hospices target beneficiaries who will have longest length of stay thus equating to a larger payout, or that it found many hospices provide insufficient care, is tragic.
However there is an important distinction between flaws in an industry and an industry that is inherently flawed.
What the NPR article fails to explain is that Medicare-certified hospices may be for-profit, nonprofit or government-owned, and the differences of motive can presumably be vast.
Hospice providers such as VNA Community Healthcare & Hospice offer hospice services as part of a larger picture of a commitment to health and wellness for the whole person, for their whole life. With more than a century of service in home healthcare behind us, our staff added hospice care just a year ago because we saw it as the bright light it can be in the lives of our patients, not as the dark cloud in the Medicare system that the OIG report seems to find it to be.
Already known as an expert agency when it comes to care for individuals with any healthcare need, we wanted to be sure we could continue relationships with our patients and their families through their entire life’s journey.
We are dedicated to being a nonprofit that serves the community and its needs from first to final days, and consider the quality of patient care to be of highest importance.
There is no doubt that it is time to shake the tree, but let us not forget that the tree of hospice care is also capable of bearing beautiful fruit.