A Washington state appellate court panel here has upheld a lower-court finding that Liberty Lake-based Family Home Care Corp. met the certificate-of-need requirements to provide hospice services in Spokane County.  

The case stemmed from a lawsuit that nonprofit Hospice of Spokane filed against Family Home Care and the state Department of Health.

Hospice providers wishing to operate a hospice or provide in-home hospice services in a given market must first obtain a certificate of need from the Department of Health before beginning operations, according to court documents.

Michael Nowling, who owned Family Home Care when it first applied for the certificate, says that most hospice services are provided to patients in their homes. If a provider wishes to operate a hospice house, where patients can go if their care needs can’t be met at home, the provider must obtain a second certificate of need, he says. In this case, Family Home Care was applying for in-home hospice service.

“Our application was for us to provide generic hospice care in people’s homes throughout Spokane County,” he says.

In September, Family Health Care sold its hospice, Medicare-certified home health, and house calls departments to Atlanta-based Gentiva Health Services Inc. The rest of the company was sold to Jeff Wiberg, an executive with Family Home Care, who retained the name. Gentiva now operates Family Home Care’s former hospice house at 22820 E. Appleway in Liberty Lake, as well as operating its in-home hospice services.    

Family Home Care, which offers services in Spokane, the Palouse area, and North Idaho, was granted the certificate after an adjudicative proceeding in May of 2011. It had applied for the certificate in 2006 and was initially denied. Family Home Care sought reconsideration of the decision, and was awarded the certificate.

Hospice of Spokane had contested Family Home Care’s application, claiming that the state erroneously interpreted the law and contending that Family Home Care hadn’t established there was a need for additional hospice services here. It appealed an administrative health law judge’s ruling in Family Home Care’s favor to Spokane County Superior Court, and then appealed a Superior Court judge’s similar finding to the state Court of Appeals.  

Hospice of Spokane operates a 12-bed hospice house at 367 E. 7th on the South Hill. It is also in the process of constructing a second hospice facility on the North Side, at 102 W. Rhoades, which will have a similar capacity. It also provides in-home hospice care. 

Tamitha Anderson, spokeswoman for Hospice of Spokane, says that while the hospice provider didn’t get the ruling it wanted, it won’t appeal the decision again. 

“Hospice of Spokane continues to remain focused on how to best serve patients and our community,” she says. 

In its argument against the court’s decision to grant the certificate of need to Family Home Care, Hospice of Spokane claimed that the state health department incorrectly interpreted a six-step methodology that’s used to determine whether another hospice provider is necessary for a given “planning area.” 

The methodology calculates the projected need for hospice services in an area, and must show an average daily census of 35 unmet patients for the certificate of need to be granted. 

Within the methodology is a step where the calculations are inflated by the estimated one-year population growth in that area. Hospice of Spokane claimed this part of the statute established a one-year planning horizon. 

However, the court found that an established three-year planning horizon applies to the need projection methodology when the statute is read as a whole. It also held that shortening the planning horizon to one year would increase the possibility of a lapse in available providers, because the application process itself takes more than six months, meaning there would be no time to prepare for an unmet need. 

“The three-year planning horizon provides greater access to health care by permitting additional providers to assist patients if need is found,” the appellate court panel said in its decision. 

Nowling, although he is no longer involved with the case, says he believes more people should take advantage of hospice services here. 

“A hospice is a great program, whoever provides it,” he says. “We were always frustrated that there was this pushback to the expansion of hospice services in Spokane County.”