Spokane Journal of Business

Another house for HOSPICE?

Nonprofit’s volumes have doubled since ’05, prompting thought of expansion

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Hospice of Spokane, which opened a Hospice House facility on Spokanes South Hill recently, says its patient volumes have doubled in the past few years and its considering opening additional facilities on the North Side and in Spokane Valley.

The nonprofit organization, which was founded here in 1976, provides medical care, counseling, and spiritual support to the terminally ill and their families, and also offers bereavement services and a childrens grief program to the Spokane-area community. Its among the largest social-service nonprofits in the Spokane area, with a budget of $12 million last year and a projected budget of $12 million this year, although thats a conservative estimate, says CEO Gina Drummond. It has 135 full-time employees, including medical directors, nurses, social workers, chaplains, and administrative staff, and about 250 volunteers, Drummond says.

Hospice of Spokane, which serves patients of all ages, has an average daily census of 275 patients, up from 135 in 2005, she says. Last year, it recorded the deaths of more than 1,200 people, up from 762 in 2004. It cares for about 75 percent of patients in their homes, and the balance are in assisted-living facilities, nursing homes, hospitals, and the Hospice House that it opened late last year, she says.

The 12,000-square-foot Hospice House, which cost $3 million to construct, is located at 367 E. Seventh, in Spokanes medical core. The facility has 12 patient rooms, each with its own bathroom and exterior access with patio space, a shared kitchen and family dining area, a living room for family gatherings, two smaller lounges, and a childrens play area, Drummond says. It also features interior and exterior courtyards, and a chapel-like reflection room that includes whats called a reflection wall, where people can post written messages to their deceased loved ones, to other patients and their family members, or to the facilitys staff.

The Hospice House has 18 employees, who provide round-the-clock care, she says. While the facility offers respite services, it primarily provides care to patients who have little time left to live. The average length of stay for patients at the facility is 8 1/2 days, she says.

Hospice House isnt long-term care, Drummond says. It serves a unique need in the community, and we want to focus on the folks who are at that poignant time when theyre at the very last stages of their life.

Hospice of Spokane, which is located in a 19,000-square-foot building at 121 S. Arthur, had been looking at opening a hospice house for the past decade, Drummond says. In 2001, it bought about 10 acres of land in Spokane Valley, but sold that site a few years ago around the time it bought the land on the South Hill. The nonprofit chose to open its first facility in the medical district to increase its visibility in the medical community and so that patients could be closer to their doctors.

The medical community has a connection to us through the Hospice House thats stronger than it was before, and that has played into our volume growth, Drummond says. We thought it was a good place to start, and it has teed us up for success in the future.

Hospice of Spokane hopes to open a facility on the North Side within the next five years, and is looking at sites in Spokane Valley as well, although that project is a ways in the future, she says.

The nonprofit plans to expand in part because it expects that demand will increase as baby boomers age.

We expect that were going to be serving more and more people, Drummond says. In time, it will make sense for us to have more than one Hospice House.Eligibility

To be eligible for hospice care, patients must have a life expectancy of six months or less and no longer be seeking life-prolonging treatment, she says. Hospice of Spokane offers palliative care, which involves treatment meant to relieve pain and to manage symptoms, rather than cure a disease.

Were not trying to buy time; were focusing on comfort and quality of life, Drummond says. Hospice is about optimizing the quality of the time that people have.

Medicare, Medicaid, and most private insurers cover hospice care, and Hospice of Spokane will provide charity care when necessary, she says, adding that it has never denied services to patients due to an inability to pay.

To promote its services, Hospice of Spokane places brochures in hospitals and doctors offices here, and its staff members meet with doctors and other health-care professionals regularly, Drummond says. Hospice typically receives patient referrals from health-care providers and from patients loved ones, and occasionally, patients will refer themselves, she says.

Once Hospice receives a referral, it will verify with the patients doctor that the referral is appropriate, and the patient must sign consent and insurance forms in which he or she agrees that care is intended to comfort, not cure.

Part of whats driving Hospice of Spokanes growth is the relationships it has built with members of the medical community here, she says. In particular, the nonprofit has focused more on pediatric palliative care in the past few years, mainly because of its relationships with health-care providers who specialize in pediatric care, she says.

Doctors are key, and the hospitals are paving the way for us by connecting their patients with Hospice, Drummond says. We focus on strengthening those relationships and chipping away any barriers between us and patients.

Hospice of Spokane has worked to simplify the referral process so that its easy and efficient for doctors to get their patients signed up quickly, she says.

If (health-care professionals) see us as helpful and supportive, well get those referrals, she says.

Hospice of Spokanes growth also is being driven by a general shift in societys attitudes toward hospice and end-of-life issues, she says.

As a society were a lot more comfortable talking about hospice, and with the notion that we all die, she says. Theres a lot of value in a good ending.

Drummond credits the baby boomers partly for that attitude shift, and says that they have contributed to Hospice of Spokanes growth by seeking out services for their ailing parents.

The baby boomers are educated consumers; they know whats out there, she says.

Although Hospice of Spokane expects to continue growingly strongly, its also facing hurdles to that growth. For instance, its struggling to find qualified nurses, who are a scarce resource here, Drummond says. It also spends a lot of time educating new employees about the philosophy of hospice care and how its different from traditional medical care, she says.

Rising gas prices also pose a challenge, since hospice workers have to drive to see the majority of the organizations patients, she says. Meanwhile, the Centers for Medicare and Medicaid Services is moving forward with a proposal that would cut hospice reimbursements significantly, which would create another obstacle to growth, since more than 80 percent of the organizations revenue comes from Medicare beneficiaries, she says.

The nonprofits various revenue streams include United Way, philanthropic support, and reimbursements from Medicare, Medicaid, and private insurers.

Contact Emily Proffitt at (509) 344-1265 or via e-mail at emilyp@spokanejournal.com.

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