Northwestern's home hospice in limbo
Employees told to look for work at program that cares for dying patients
08/15/2012 10:00 PM
Northwestern Memorial Hospital’s Home Hospice program, one of the oldest of its kind in the country, could soon be up for sale.
Home hospice offers services that relieve pain and suffering for terminally ill patients. Often applied to cancer sufferers and those who have been give less than six months to live, the services shift from treatments and recuperative efforts to ones focused more on emotional support and fighting the symptoms of life-limiting ailments in the patients’ final days.
The programs, which are available in hospitals and through private care providers, have only been in practice in the United States since the mid-1970s.
As one of the country’s preeminent academic medical centers and primary teaching hospitals, Northwestern Memorial boasts a well-known home hospice care program. But that institution could be seeing a change in the coming months.
Northwestern Memorial spokeswoman Kris Lathan recently said that the hospital was “exploring options” to sell off the 26-year-old business.
Lathan said that the move was “spurred by a decision to focus on our core adult tertiary care model.”
The hospital’s home hospice staff includes physicians, social workers, pastoral counselors and bereavement counselors, along with volunteers and other healthcare professionals who provide “holistic, home-based support to patients and families.”
Lathan did not give details on what that deal might look like — namely, whether the sale would include the transfer of the program’s employees or the use of the hospital’s home hospice offices, at 676 N. St. Clair St.
“It’s too early to speculate on unknown aspects of a potential sale,” she said.
But a source close to the hospital told Skyline that home hospice employees had been told the program might close and that they should seek work elsewhere.
Lathan said that the word of the program’s potential closure was a rumor.
There are currently more than more than 4,700 hospice programs in the United States, with around 1.5 million people being treated through Medicare-funded programs annually.
As services become more widely available, the demographic of care recipients has expanded and changed over the last few decades. According to a congressional report by the Medicare Payment Advisory Commission, the country’s typical hospice user has shifted from the early 1990s, when many were cancer patients “who lived at home in an urban area.” But by 2000, there were a growing stock of non-cancer patients living in nursing homes or rural settings. The percentage of hospice patients dying within one week of admission jumped from 21 to 30 percent during that same period.
In most programs, patients spend the bulk of their time outside of the hospital — a caveat for Medicare qualifications, said Naomi Naierman, president and CEO of the American Hospice Foundation, a nonprofit organization that advocates for hospice care programming.
That can make it hard for home hospice programs to turn a buck. Hospitals make more money when patients spend time in their clinics, but Medicare often calls for no more than 20 percent of the patient’s time to be spent at the hospital.
When you add that to short stays for dying patients, the programs are increasingly squeezed.
“You have to justify keeping someone in an inpatient home hospice care for more than five days,” she said. “You have to prove that it is absolutely necessary.”
Without speaking directly to the program at Northwestern Memorial, Naierman said profitability is not always the greatest obstacle for inpatient hospice care programs.
In cities like Chicago, where there are currently around 40 home hospice practices in operation, the competition for attracting patients can sometimes be stiff, Naierman said.
“The demand may not justify the supply,” she said.