Hospice reaches service goals

TUPELO – Early interest in Sanctuary Hospice House’s new home hospice service indicates the facility will be able to meet Medicare requirements that will kick in next year.
The organization, which cares for terminally ill patients, already has made 10 admissions to its home hospice program that began Sept. 1, said Executive Director Linda Gholston.
Sanctuary Hospice House was the first inpatient hospice service in north Mississippi when it opened its doors in November 2005 and has cared for nearly 1,000 patients. As part of a five-year federal demonstration project, Sanctuary was exempt from Medicare’s 80/20 rule. The rule requires hospice facilities to balance their patient load with no more than 20 percent receiving general inpatient care.
However, the study will end Sept. 30, 2010, and Medicare has made no move to make the exemption permanent. So for Sanctuary to continue, it has to take on a home hospice component to be able to continue to offer the high-level care for patients at the facility.
“For us, the community has been so supportive to Sanctuary, that there just wasn’t a choice of closing,” said Lauren Patterson, head of the board of directors.
Hospice services focus on providing care to terminally ill patients who are expected to live six months or less. It focuses on controlling pain and symptoms so patients are comfortable and can spend time with family and friends.
Medicare divides hospice patients into two groups – residential and general inpatient.
Under general inpatient, people need a higher level of care from registered nurses that typically can’t be carried out at home, Gholston said.
“Before Sanctuary was here, they would have ended up in the hospital,” Gholston said. “Here is much more appropriate for a patient and family as death is imminent.”
Residential patients can be cared for at home, if they have an appropriate caregiver. These patients may only need a registered nurse once a day or every few days. Sanctuary fills a need for terminally ill patients who don’t have an appropriate caregiver for any number of reasons. It gives them access to hospice services they couldn’t receive at home.
“Before Sanctuary, there were people who fell through the cracks because they had no caregiver, who died without appropriate care and died in pain,” Gholston said.
When Sanctuary analyzed its records from the first eight months of the year, they found they averaged about four to five patients out of a possible 16 in the house who needed the higher level of care.
To meet the Medicare requirements, Sanctuary can count residential patients at the facility, and the home hospice division needs to average between 10 and 12 patients a day.
“We want to be available to serve anyone,” Gholston said. “We won’t hold the number to match what we have to take.”
Sanctuary will continue to take referrals from hospitals and other home hospice organizations.
“The hospice community has been very gracious,” Gholston said. Sanctuary officials had face-to-face meetings with all of the area home hospice providers to tell them about the decision for Sanctuary. “They understand this is the only option to have the hospice house.”
When there is a waiting list for admissions, Sanctuary will focus on taking the person in greatest need of the hospice house services, Gholston said.
Sanctuary Hospice House’s annual operations budget is about $2.5 million. Reimbursements provide about $1.4 million. They raise another $1.1 million through Celebration Village, the Sanctuary Village Shoppe, memorials and other donations, Gholston said. The home hospice division should be financially self-sustaining.
At this point, Sanctuary has added one full-time and one part-time registered nurse, an aide and expanded the hours for its social workers, Gholston said. Sanctuary volunteers, including chaplains, also will be working with the home program.
“Our commitment is to provide the same excellence as at home,” Gholston said.

Michaela Gibson Morris/NEMS Daily Journal