Hospice Census Numbers Dropping?

Of late, there has been a general rumbling in the hospice community - census numbers are dropping or leveling off. Have you been affected?

Economy, Medicare Regs likely to blame

Determining exactly what's leading to the drop is difficult to say; However, many experts believe the present economic system is playing a part. If people are not willing to spend on optimal medical care, and to put off necessary medical care, physicians and hospitals may have started to feel the pinch, resulting in a trickledown effect or lower hospice referrals.

Medicare regulations may also be taking a toll on hospice referrals. A recent column on the Kaiser Health News Web site suggests that new rules like the physician narrative are making physicians less likely to refer patients to hospice until they're actively dying.

Do not throw in the towel as yet

It is a tough time, but there are actions you can take to help keep your hospice afloat so you can continue to care for the patients who require you. Think about the following suggestions:

Broaden your referral base

If you are depending on hospitals for referrals, it is a good time to look elsewhere. Try to improve your relationships with individual physicians. Think about getting the word out that you're available to provide hospice services for younger terminally ill patients and other non-Medicare-covered patients with conditions like AIDs, multiple sclerosis, amyotrophic lateral sclerosis (ALS), and cancer.

Take a second look at nursing home relationships

Can you broaden the number and types of patients you care for in your present nursing home partnerships? For instance, could you assist with residents in an assisted living unit? Are there ways you can help with older and frailer patients that you do not have under your current contract?

Think about new partnerships

When the times get difficult, it may be time to look for new ways you can create mergers and partnerships with other hospices or home health agencies.

Now's also the time to think about how you can team up with other providers to take care of those who require your services. There has been some movement among various types of providers to begin their own palliative care programs. Think about approaching such programs - often found in continuing care retirement communities, hospitals, and nursing homes - to see how you can work together to provide the patients with better care.

Jan Mater-Cavagnero MA, HCS-D, specializes in diagnosis coding for homecarenews.inhealthcare.com home health agencies, as well as the wide variety of issues that impact the hospice industry. Jan is an editor-in-chief for Eli Healthcare, where she has written Home Health elihomecareconnection.com ICD-9 Alert for five years.