What The Hospice Companies Don’t Want You To Know

In which Dad & I continue our education regarding corporate health care.

Dad likes doctors who speak plainly to him.  It’s a big part of what he likes about Dr. Primary (his primary care doctor), Dr. Pisser (his urologist), Dr. Onco (his oncologist), Dr. Tootsie (his podiatrist), and even Dr. Twitchy (his neurologist).  In fact all of these doctors have been specifically chosen as much for their ability to communicate with Dad as for their medical skills.

not actually Dr. Primary

Not actually Dr. Primary

So it was actually a bit of a relief to Dad when Dr. Primary told him “you probably won’t see Christmas this year.”  It can’t be put much more plainly than that.  Dr. Primary also suggested that it was time that we got Dad into a hospice program.

Now, since we’ve been through this once before with in-home care (you can read all about that thrilling episode here), we knew that Dr. Primary would refer us to Dr. Asshat’s Lying Thieving Hopsice Company.  And sure enough, as we walked out of the office Miss Useful (the scheduler) offered to set us up for an “intake visit” from Dr. Asshat’s Lying Thieving Hospice Company.  I nearly declined on the spot, since I knew that there was no way we would be using

this is actually Dr. Asshat

This may actually be Dr. Asshat

Dr. Asshat’s Lying Thieving Hospice Company.  But then again I thought, why not waste some of their time – and they may provide a useful comparison point.  So we set up the visit with Dr. Asshat’s Lying Thieving Hospice Company.

As soon as we got home, I googled up other hospice companies in our area.  I decided that Happy Hospice company looked like a good candidate, so I called Miss Useful (and only had to talk to 5 of the Useless C’s before I could talk to her) and asked her to also set up an “intake visit” with Happy Hospice.

Now the fun begins!  Miss Useful informs me that it isn’t usually

The Tree of Hospice Caring

The Tree of Hospice Caring

done this way.  Usually she only writes one referral and that is the company that we would use.  This of course pisses me off.  So I bluff.  I remind her that the law requires her to write the referral to whatever agency or agencies that WE choose (I have no idea if this is true or not – but it worked)!  So she backs off and does what I asked.  Score one for the home team.

The visit with the woman from Lying Thieving Hospice Co. actually goes pretty smoothly and even starts on time.  She paints a wonderful picture of the caring team of professionals who would look out for Dad’s best interest for the remainder of his life.  She assures me that that the Lying Thieving Hospice Company is nothing like those lying thieving bastards at the Lying Thieving Nursing Company.  Even though Dr. Asshat is the “Medical Director” for both firms, she assures me that they are nothing alike.  I give her all of Dad’s information, including his list of medications.  She looks it all over, declares that everything is wonderful – and if Dad will just sign on the dotted line we can start making the magic happen.

Won't this be wonderful

The happy picture of a caring hospice worker

Of course she is very unhappy when I tell her that we will also be hearing the sales pitch from the Happy Hospice Company and that we won’t be signing anything until after we evaluate our options.  She has “never heard of such a thing” and leaves in a bit of a huff.

The following day we get our visit from the Happy Hospice Company.  Five minutes before the scheduled time, this woman calls us and tells us that she will be running half an hour late.  She doesn’t ask if that will be O.K. with us – she just informs us that she’ll be late.  She arrives at T+30, and proceeds to spend the next 10 minutes talking on her cell phone in the driveway.  She then comes in and informs us that we’ll get started as soon as the nurse arrives.  At T+60 the nurse arrives.  I inform them that this is a bad sign, if they can’t be on time when they are trying to sell us their services, how are they going to treat us after we’ve signed up?  She informs me that this is not a sales call, it is an “intake visit” and the purpose of the visit is to sign us up and get the service started.  I’m not sure how that is actually different from a sales call, but whatever.

I’ll give the Happy Hospice Co. nurse credit.  She looks over Dad’s list of medications (the same list that I provided to the Lying Thieving Hospice Co. worker) and informs us that we will “of course have to discontinue the Zometa.”

it builds strong bones

Zometa - it builds strong bones

Zometa is a drug that Dad gets through an IV once a month.  It doesn’t actually do anything with regards to the cancer cells that are rampaging through Dad’s blood stream.  What it does is strengthen Dad’s bones so that they are better able to resist the cancer cells from eating away his bones or setting up housekeeping in his bones.  It is good to keep the cancer out of the bones, as it can be VERY painful if the cancer metastasizes in the bone.

This is a very expensive medication – about $1,200 per treatment.  But as we’ve previously covered, Dad has great insurance that pays for this treatment.  I explain to the Happy Hospice nurse that Dad’s insurance will cover the treatment, so we don’t see any need to stop it.

And this is where I get my next lesson in the business of health care.  The nurse explains to me that once Dad enters into a hospice program, Medicare picks up all of the costs.  However, any Medicare supplement that you have will no longer cover any treatment related to whatever caused you to enter hospice.

At this point I decide that we need to regroup and study the situation some more.  So I send the ladies from the Happy Hospice Company on their way (they too are disappointed that we won’t sign anything) and start researching some more.

This issue is particularly troubling to me, since the Lying Thieving Hospice Co. didn’t seem to have any issue with Dad remaining on the Zometa.  But, as their name implies, the Lying Thieving Hospice Co. isn’t exactly known for their honesty.  So I call them up and ask specifically about Dad’s Zometa treatment.  The charming and delightful person at the Lying Thieving Hospice Co. informs me that “of course he’ll have to stop the Zometa, it isn’t covered.”  Wow!  It sure would be nice of them to tell us that before they ask us to sign on the bottom line.  They decide that they should schedule Dr. Asshat himself to come to our house the next day to explain it to me.

In the meantime I do some more research.  The nurse from the Happy Hospice Company was telling the truth – as far as she went.  Of course she didn’t tell the whole truth.

the whole purpose of hospice

Hospice Mission Statement

“Standard” hospice companies work exactly as she explained.  When you enter hospice, Medicare takes over the complete cost of hospice.  Any Medicare supplement that you happen to have is no longer in effect for the disease that caused you to enter hospice.  And since standard Medicare doesn’t cover Zometa, you can’t have it if you are in a “standard” hospice program.  Actually that isn’t entirely true – the “standard” hospice company could still let you have the treatment.  But Medicare won’t reimburse them for the cost of the treatment.  So the hospice company would have to pay for it out of the per diem that Medicare pays them for everyday that you are in the program.  But since this would cut into the profit margins, no “standard” hospice program will let you have the treatment.  Remember, it isn’t about the quality of care or quality of life – it is all about the profit margins!

But my research tells me that if you select an “open access” hospice program instead of a “standard” hospice program – you get to keep your insurance!  This sounds like what we need.  In fact, it sounds like how hospice should work.

keep gubmint outta my healthcare

A Common Insurance for Hospice Patients

Most people who need hospice care, I’m assuming, are on Medicare already.  And if they are smart or fortunate, they have a Medicare supplement.  So why would you not be able to use your Medicare supplement to help pay for medical care that you want or need?  Can anybody explain this?  How does this make sense?

The following day, Dr. Asshat arrives to explain things to us.  First, he explains that while Dad cannot have further Zometa treatments, there are oral medications that work “almost as well” that he could still receive from the Lying Thieving Hospice Company.  Then he proceeds to tell us that Zometa is “a bad medication for your father.”

Now hold up there a minute doc!  If Zometa is a “bad medication” then why would we want an oral substitute that works “almost as well?”  Would “almost as well” mean “not quite as bad?”  What are you talking about?  I held that thought and instead asked “Why does Dr. Onco keep him on the treatment if it is a bad medication?”

Dr. Asshat’s well thought out answer to my question was simply “I’m not going to argue the literature with you, you wouldn’t understand anyway.”  EXCUSE ME!  EXCUSE F’n ME!  Who do you think you are?

But I knew that open rage wouldn’t really help Dad, so I managed to hold my tongue for a change and instead asked about “open access hospice.”  You know, the kind of hospice where Dad could still use his insurance to pay for the Zometa treatments?  Dr. Asshat, in his eternal wisdom says “I’ve never heard of that.  I don’t believe that anybody would actually do that.  It would be illegal.”

alternate literature

I don't know doc, can we look here?

Now I’m not a doctor with a degree.  I probably don’t understand “the literature.”  I’m not the Medical Director of two different Lying Thieving health care companies.  But I do know how to use Google.  You, gentle reader, probably do too.  So go ahead, google up “open access hospice” and see what you can find.  That’s right, you’ll find literally hundreds of “open access” hospice companies.  Apparently they are all illegal, if you believe that Dr. Asshat has a clue.

We have since regrouped, and located three different open access hospice companies that service our area.  We have interviewed the first of the three already, and we were very impressed.  Keep your fingers crossed for us in this search.

And here are some tips and tricks if you need to find hospice care for yourself or a loved one.

* Read up on everything you can about hospice.  There are reportedly lots of good hospice companies, and I can tell you first hand that there are lots of bad ones.

* Use your yellow pages.  Google only gave me two hospice companies that serve our area – Lying Thieving Hospice & Happy Hospice.  The yellow pages gave me five companies.

* If you have a Medicare supplement, or other private insurance, you REALLY want to find an open access hospice company.  DO NOT settle for anything else.  You have insurance, you should be able to use it.

* Check, double check, and triple check EVERYTHING.  These companies will do or say anything to get your business.  Do not simply trust the referral from your doctors office.  There are lots of options – find the best one for you and your loved ones.

* Make sure that the hospice company that you select provides an emergency kit of some sort.  This emergency kit usually contains medications to ease breathing and manage pain.  They often include some form of morphine.  This kit could be a big time blessing in the case of emergency pain.  Do you really want to wait half an hour for the nurse to arrive, or do you want to (at their direction) get your loved one some relief NOW?  Believe it or not, not every hospice supplies such a kit.  Make sure that yours does, and make sure that you know what is in it.

* During the sales call (or even before if possible) provide the hospice company with a complete list of medications.  Make sure that they understand and verify YOUR desires with regards to current medications.  YOU must dictate to them, do not let them dictate to you!

* There are lots of good websites that give suggestions about choosing a hospice provider.  None of them that I’ve found mention “open access.”  But they do have lots of good ideas.  Read them all!  This is a very important decision.  Make it carefully.

As usual, the names of the health care providers & companies have been changed mostly for my amusement.  If you want to know any of their real names, e-mail me privately.

Prop It Up

Advertisements

37 comments on “What The Hospice Companies Don’t Want You To Know

  1. Whitey Bell says:

    Ih My God Jim I loved the 5 useless Cs line I was laughing so hard at that. I could just imagine you losing your mind dealing with these people. Hope your search goes well and you get your Dad the best help.

  2. Sharon says:

    Jim this is fantastically written and you have stayed in the control chair which is KEY. How quickly they are to think they can just dismiss you! Also if this is how they treat you during the sales pitch (and yes I have worked at two hospitals, the word customer and patient become intertwined) imagine how you and especially your Dad would have been treated if you signed on the dotted line? Way to man up and own Dr Asshat!!

  3. […] to enroll him in a hospice program (for some of the trials and tribulations of that search, click here).  After a lot of researching and interviewing we selected the Big Statewide Hospice Company.  BS […]

  4. Karen Tyson says:

    I love it!

    We went thru a warm-up for this phase when searching for a nursing home for my mother-in-law almost a year ago. She was on the opposite end of the scale as far as care benefits, but with hot tips from “A Place for Mom” reps and off-the-record advice from professional staff at the rehab center (through which we guided her following the umpteenth 911 ride to the hospital) she is now safely, comfortably, and usually happily living at a modest local nursing home, compliments of Medicaid. My husband brings her mocha and Dove 3-4 times a week and she tells everyone what a great place she has, how nice the people are, and what tasty food they serve. She has her crazy episodes (which may be a product of her long list of meds) but when that happens the nurses order doctors’ attention and med evaluation, then adjustments are made.

    Thank you, Jim, for this insight to our eventual venture through hospice care!

  5. Velon Willis says:

    I love this article. You are awesome and giving me clue to deal with the Lying Thieving Hospice that was refereed by the hospital. And the Lying Thieving Hospice does’t even know who they are accredited with?? LOL

    Here is a checklist of questions you may want to ask each hospice care provider:
    Are you a non-profit hospice?
    Is hospice your primary business or is hospice an add-on to another business?
    How long have you served our community?
    Are you Medicare and Medicaid certified? Are you state certified?
    What certifications do your Medical Directors have? (Medical directors should be Hospice and Palliative Care Board Certified)
    What is your nurse to patient ratio? Social worker to patient ratio?
    What kind of support is available to the family/caregiver?
    What does the hospice volunteer do? How many are available in my area?
    How do you work to keep the patient comfortable?
    How are services provided after hours?
    How and where do you provide short-term in-patient care?
    Which nursing homes or assisted living facilities do you work with?
    How long does it typically take you to admit someone once the request for services has been made?
    When will the nurse make the first visit?
    How often are grief support groups offered?
    Are there programs and/or planned events within the hospice to help family members heal and grow?
    Are you accredited by a national organization, such as CHAP or JCAHO?

    Hope this helps..

    Velo

    • Holley says:

      Tax status does NOT make a difference (for profit or not for profit). I agree that open access is important, as is Crisis Care staff availability: Ask what they provide for a short term medical crisis– do they staff with nurses (vs. aides) and how do they ensure they have enough nurses to cover multiple cases?

    • Sandra Suarez says:

      Non profit and profit hospices can be equally as bad – not a good indicator. I’ve worked for both.

  6. Girlie says:

    Well I must admit this article left me laughing and mad. Not all Hospice companies are out to get the public, my dad had the greatest company even though they were new and not yet accredited, it was a brand new start up.We were referred by our trusted family doctor who has nothing to gain from the referral, he knew the nurse who was in charge and was really impressed with her dedication.Dad opted to stop dialysis , this meant stopping his epogen, a blood building medication , which gave him energy and strength.We understood that the Hospice would not pay for it but also that dad choose Hospice and he saw no purpose to this, he wanted to donate all he could to research and helping others.The writer is very cynical, bitter and angry all emotions that go along with loosing a loved one.Hospice companies are no different than many other companies, there are some better than others, I never knew about the open access bit, will surely check that out.Remember if you act like a smart ass and a know it all your family member will be less likely to get the best of care no matter where you go.

  7. sergio says:

    Just a remainder hospice is a palliative care.

  8. Janet says:

    FYI only large hospices (+200 patients on service any given day) can absorb the costs of being open access. As you corrrectly indicate, discontinuing the drug your dad was on would put him at great risk of increased pain. Any hospice that could not afford the cost of his monthly injection should have honestly said so and refered your dad to another hospice that could. However, beware of hospices that get your business by promising they are open access. They may agree to pay for a particular treatment just to get your business. The plan is to talk you out of it once you sign up. A small hospice that is honest and tells you that they will not/can not provide the treatment, may actually provide much better care overall. Unlike your Dad’s situation, not all treatments recommended by physicians are really necessary.

  9. susan says:

    first let me tell you how sorry i am about the loss of your father. it’s tough.
    i would like to know the name of the home health agency and hospices you interviewed. i have been a home health and a hospice nurse and find your story appalling.

    • gscott says:

      It is appalling, but it’s also accurate, 100%, based on my own experience with hospice. It was appalling to see how little hospice did; the lengths they go to and the bs they say when questioned for the subpar care they provide. Yep, appalling and hospice – those two words go together.

  10. SThompson says:

    I read your public profile. You’re amazing. God bless you during this difficult time. I will only point out that the medication in question does fall under the category of a treatment med which is not covered by medicare during hospice care. There are however ways around that which is what open access is all about. It assists with issues like this one and others that fall through cracks. I CAN believe that Lying thieving no darn good piece of crap Hospice Company was intentionally deceptive ( I sort of changed the name) and it appears they avoided the topic…first by not addressing it at the forefront of the process before intake even started and then by lying about open access. If the doctor never heard of that…well he/she is like so many doctors who are not really familiar with insurance companies and reimbursement methods. …which is another ball of wax we cannot really start with right here..OR he knew about open access and didn’t want to lose you as a customer…and that is a doctor that I wouldn’t trust with the care of my family members. Either way it’s just unfortunate that you were given so much trouble. What nerve you have! How dare you be an educated health advocate! (Thank you for sharing your story, your frustration and the insight you offer is invaluable).

    • jehingr says:

      Thank you for your kind words. It’s so sad that something like hospice, born out of compassion, has become about nothing more than profit.

  11. Suzan Holten says:

    Ovarian Cancer, 4 years now. My Hospice does not like my choice of Oxycodone for short term pain relief. It only comes in 15mg doses unless you want the abuse proof brand by Purdue Pharma. I must take too many! They would like me to check into facility to “better monitor my pain.” I’m able to take care of myself, and have a spouse. I figured out they want me to take Methadone-to get me off those terrible additives. Do they really have to make sure I’m drug free before I pass to the next world? Do they drug test there also?

    • jehingr says:

      Explain to them that you are the customer, and want what you want! If they don’t want to, remind them that they are are bound by law! And they are not the only hospice company.

  12. rebekah says:

    My mom just dropped the bombshell on me that she has entered my dad (who is suffering with Alzheimer’s miles away from me) into hospice care. She prefaced the announcement by saying that it “doesn’t mean what it used to mean” (as in 6-months or less to live) and that he could live a couple years or even more, and he could get better and be taken off hospice.

    Your blog was one of the top results that showed up in my search for an answer to the question of whether criteria for entering hospice has changed. I don’t know that my question has been answered, but your blog has really helped me in formulating more questions that I hadn’t even thought to ask. Thank you for sharing your own experience and doing so in a manner that brings a few smiles in the midst of navigating difficult and unfamiliar territory.

  13. jimmi says:

    Wow……..as a hospice nurse I must say the side effects of Zometa are vast. Your loved one has chosen hospice, the way pain is handled goes to a new level, patients often feel obligated to continue doing things to comfort the family. In fact getting the family to quit feeding the patient can often be a hurdle, but at the end of life people are not hungry. I’ve had patients hide food in there beds because the family was pleading with them to eat. You should discuss what dying with dignity means to your loved one.

    • jehingr says:

      How condescending to assume that Dad & I didn’t have that discussion. But then again such arrogance is typical of hospice workers. Everything I did for my father was a direct result of his expressed wishes. Shove your uninformed opinion where such shite belongs.

  14. Having not only worked for a Hospice Agency, but also using that same agency for my dear mother, who passed from ALS, I take offense to your article and cynicism.
    People of Medicare age, can elect to have their hospice benefits, called the Medicare Hospice Benefit, or they can have Home Health services, which is not palliative care, but also furnishes your loved one with skilled nurses, therapists, bath aides and social workers as well as chaplains and a whole bevy of supportive services including but not limited to; support groups and respite care.
    What people need to know, but obviously don’t, is how hospice agencies are reimbursed, what they are charged for, what they cover and what a “per diem” rate is.
    Do you know that, typically, physicians don’t make referrals to hospice agencies until their clients are practically actively dying? This is so sad on many levels, the first being the dying soul who has missed out on the spiritual support, symptom management and help that the hospice agency provides not only him/her, but their family as well.
    Second, it fiscally mal affects the hospice agencies and this is why.
    The member signs the Hospice Election Benefit form and by doing this, the “pot” that the government typically pays that patient’s physician for all of his/her yearly care, is now reimbursed to the hospice agency as a daily rate, which is minimal at best. Out of that daily payment, the hospice agency is responsible for paying for all of that patient’s medications, and needs, related to their terminal diagnosis. These medications can include highly expensive narcotics to control end-stage disease process pain, that can run in the hundreds per day; durable medical equipment rental and purchases including (but not limited to) walkers, wheelchairs, bedside commodes, hospital beds, suction equipment and tubing, oxygen, Foley catheter and supplies. I could go on ad-nauseum.
    A person who is in the end-stage and actively dying, requires much of this durable medical equipment, as well as typically heavy doses of expensive medications to keep them comfortable through their final process. Just admitting, providing supportive services, DME (durable medical equipment) and the medications it takes to keep a dying person comfortable is extremely expensive, and the agency has had little to no time to build up an “account” if you will, to cover the cost of this person’s needs. Therefore, the agency goes “in the red” on those patients who are admitted and die soon thereafter.
    Therefore, it’s is highly beneficial to not only the patient, but the hospice agency, for a patient to admit to their hospice benefits months in advance of their terminal prognosis. This way, the hospice has the opportunity to actually “build’ an account to cover the patient’s high cost of care, which dramatically increases the closer they get to death.
    The benefits to the patient, in admitting to the hospice agency at the earliest possible date, is they are able to build a trusting relationship with the staff, they have access to good medication management, bowel management, they have the years of experience of the caring staff to draw from when it comes down to emergencies, pain management etc. Hospice agencies also continue to provide supportive services to families well after their loved one has died.

    The focus of hospice agencies isn’t to MAKE MONEY, but they do need to make money to provide the necessary care and services required.

    I’m sorry for those of you who have had bad experiences. My family experienced tender caring professionals to whom we are very grateful.

    • jehingr says:

      Sorry to upset you by sharing the FACTS of our experience with hospice companies. My father was in the “care” of hospice, so they had plenty of time to gouge the government. The fact is that profit is the driving force behind any force behind every for profit company.

      The thing that bothers me most is the dishonesty. The referring physician never discloses that he only refers patients to his own hospice company (or at least the one that gives him the biggest kickback). They never mention that the patient can choose any hospice they want. If it is all aboveboard, then why all the deceit up front?

    • stevemoran197 says:

      This comment is really frustrating. IF IT IS SUCH A TERRIBLE THING TO BE IN THE HOSPICE BUSINESS THE GET OUT!

  15. Sandra Suarez says:

    WONDERFUL article! I am actually a hospice nurse who is thinking of starting a consulting business to help people navigate through this nightmare – it is absolutely awful what I have seen and continue to see. Thank you!

  16. Lynda Marroletti says:

    Please understand that the main difference between a non profit hospice company and a for profit hospice is simply that they need to take on a certain percentage of patients that have no payor source. For this they get certain tax credits. They are otherwise paid exactly the same way a daily rate approximately 130-150.00 per day for the care of the patient including paying for the staff, medications, medical supplies, equipment, and running of the administrative duties and office. I was an administrator for a profit hospice for 5 years. There is a very small profit margin and face it this is the system our country has chosen by having a free-market, corporate driven, capitalistic health care system.
    You are right though some larger corporations can afford to pay for more expensive treatments. Non profit companies almost never pay for extended services or expensive medications. The new medicare D regulations just out this year have made it even more difficult for patients and hospices because now all medications not just related medications have become the responsibility of the hospice. SO most hospices will be asking patients to stop all non palliative treatments and medications.
    All in all remember that most hospice workers are not doing it to get rich they are called to help people who are suffering and want to make end of life comfortable and dignified.

    • jehingr says:

      I understand the difference between for profit & not for profit. Do you understand the difference between honest and dishonest?

      That was my main point, which obviously sailed right over your head. Referring physicians should be required to disclose their financial relationship with the hospice that they are recommending. They should also be required to inform the patient that they may choose any hospice they want. Way too many people think “hospice is hospice” & they HAVE to use the their doctor picks.

      I’m sorry that you don’t get why this morally criminal behavior angers me. But that just means that you are like most hospice providers.

      And while we are at it, let’s explain how per diem works. We enrolled Dad as soon as possible. So while there were many weeks where hospice did nothing for Dad, they still collected their per diem every day! So there were many days that they got paid for doing nothing. They should have been able to use some of that PROFIT for his benefit.

      Honesty is the best policy – but the hospice system, from referral to death, has institionalized deception. And you seem to be very proud of that!

  17. Fayez says:

    Made my day

  18. Wayne Kule says:

    My dad has good and not so good days. He is on hospice now for one year. Hospice will not re-certify him if he has 8 weeks of good days. What happens when he has another bad day? How can I keep him on hospice? I do not want him on again off again.

  19. Audrey Ryan says:

    Having worked with hospice in five different states I am looking to find out a good one in Miami Florida for my sister. They refuse to give her the fentynal patch (low dose) as her current meds only last approximately 1 1/2 hours. She has cancer everywhere and now her bowels are starting to impact and I am sure she has blockage as liver is huge although she started with uterun cancer. They keep increasing her methadone making the bowel issue worse. She is allergic to moraphine and she is suffering terrible. Me I am pissed. Having worked in medicine 34 years I have never seen hospice folks so not caring and doing nothing to help her pain. They say they don’t use the fentynal patches nor liquid meds other than morphine. What bullshit. They say pills only yet if bowel full of stool there is no way the meds can get thru the GI tract to work. Please advise.

    • jehingr says:

      It is pretty apparent that you know much more than I on the medical side of this.

      I know nothing about the process of changing hospice providers, but in your case I would certainly investigate. Find a company that will provide effective meds for your sister. Just the threat of changing providers may be enough to get the current provider to reconsider. There are no rules about what they can provide, except for their own cost saving rules.

      Good luck to you & your sister.

  20. Emma says:

    I have worked for hospice for almost 20 years. We are not the enemy here. So the name calling is pretty rude. You should direct your anger at the insurance companies. The “happy lying hospice” company has nothing to do with what medicines one can or cannot take during their stay with us. I am not a fancy upper management type. I am a lowly CNA pione so I am not someone trying to protect my own interests here. I truly enjoy working for hospice. They are a wonderful and we do indeed take the very best care of our folks we are capable of. Maybe you should write another post about the evils of the insurance companies. They are the biggest problem in healthcare.

    • jehingr says:

      Thank you for your uninformed opinion. The only insurance company at play is the government, which pays the hospice corporation a daily fee for the patient. What the hospice company does with that money is pretty much up to the hospice company. There are no rules on what drugs a hospice company can or can not buy. That is why changing hospice providers can change the drugs provided. It is all about how deeply the hospice company wants to cut into their profit margins.

      Thanks for playing.

      • David Huber says:

        The current per diem is hardly more than a good hotel. Hotels don’t feed you or have personal attendants or trained medical staff. The dont have a social worker or a horribly complicated reimbursement system. I dont think that $180 per diem is all that much that you should complain about the service you get. Some people actually save for such events and live in luxury while dieing.

        • jehingr says:

          The per deem was known to the provider before they took on the patient. Hotels exist solely to make a profit off their customers. Are you sure that is the comparison that you want to make? By the way, hospice doesn’t feed you, or provide personal attendants. And the amount of trained medical staff that you see is depressingly low. It’s a free market, so the customer is always free to question the value gained.

          I’m not sure what your last sentence is saying? Are you questioning my father’s finances? Are you saying that if you have enough money 💰 that you get to die in luxury, but if you are less than rich, you should be grateful for whatever you get? You sir are an asshole. How much money 💰 do you have saved toward your luxury demise?

  21. Dave says:

    Even now with a number of years having passed your hospice comments are still valid and useful. Thank you for all of them. Have helped my wife and I get a better approach for a hospice for her mother. The wife has shared with a number of folks too. We hope you are still doing well. Take care!

  22. Grateful for common sense says:

    I have researched for weeks looking for some way to be able to have control over medications given if hospice is included. Thank you!!! Your no nonsense approach is just what I needed and knowing about “open access” is the answer I’ve been trying to find. It’s too bad those who claim to want to help us most couldn’t teach us the same.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s