NHPCO Meets with CMS Administrator Seema Verma

Written by Judi Lund Person, Vice President, Regulatory and Compliance

On Wednesday, December 13, NHPCO’s President and CEO Edo Banach and I attended a productive meeting with CMS Administrator Seema Verma. Hospice Action Network board members Mark Murray, a hospice provider in South Bend, Indiana in Seema Verma’s home state, and Angie Sells, from AseraCare, a multi-state hospice provider attended the meeting as well and eloquently represented the hospice provider voice. The planned agenda for our meeting with Administrator Verma included a quick review on facts about hospice, our response to the Centers for Medicare and Medicaid Innovation (CMMI) request for information and progress on the Medicare Care Choices Model (MCCM), the impact on hospice when Medicaid managed care is in place, and concerns related to  Hospice Compare.

Pictured at the NHPCO office pre-meeting are NHPCO Vice President of Regulatory and Compliance Judi Lund Person, AseraCare President Angie Sells, NHPCO President & CEO Edo Banach, and Center for Hospice Care President & CEO Mark Murray.

On Wednesday afternoon, we made our way to the Hubert Humphrey building in downtown DC to meet with Administrator Verma.  She was joined by five members of the CMS staff, representing both the Center for Medicare and the Center for Medicare and Medicaid Innovation.  We began with a few quick data facts about hospice but quickly moved to a robust discussion about innovation, where we shared why the hospice and palliative care patient-centered approach is exactly in line with the Administrator’s goals for patient-centered care.  Verma was particularly interested in how hospices can be involved with patients earlier in their disease process, and we discussed the need for care navigation and coordination and how hospices are already involved in that process.

The meeting with Administrator Verma (center) was productive and informative.

We also had a discussion about the MCCM and talked about some of the limitations of the model, as well as what the learning has been.  We commented that the supportive services offered in the MCCM model are exactly what many patients need before they elect hospice.  Our hope is to build on that learning as we consider additional models.     

It was clear from our discussions that innovation is a high priority issue for the Administrator.  Our visit highlighted the skills and experiences of hospice providers to participate in models for seriously ill patients and develop new models to ensure that patients and their families have the care and supportive services they need.  We agreed to continue our discussions with Administrator Verma and CMS staff at the meeting. It was a productive and useful meeting, and we look forward to continuing to build upon the strong working relationship between NHPCO and CMS. 

How to keep #HospiceMonth alive all year long

National Hospice and Palliative Care month may be over, but the momentum generated from this year’s #HospiceMonth doesn’t have to end. All month long, the hospice and palliative care community has championed #HospiceAwareness embracing this year’s hospice month theme “It’s about how you live.” This celebration of hospice care was made “sharable” on several social media platforms and has created quite a ripple. This stream of information has encouraged people to learn more about the services provided by hospice and palliative care and for those who are unaware of the hospice philosophy to gain valuable understanding that may one day make an impact in their own lives.

Throughout the month of November, NHPCO shared posts intended to encourage everyone to learn more about the many benefits of hospice and palliative care fostering a deeper understanding of what it means to live despite facing a serious or life-limiting illness. We know many of you took part in this #HospiceMonth messaging and that you continue to spread awareness and understanding with your own creative content throughout the year. Your efforts make a difference and we thank you

I don’t know what Dame Cicely Saunders would have thought of Facebook, but for a woman who stopped at nothing to spread the philosophy of hospice and who found unprecedented means to open the first hospice, St. Christopher’s Hospice to the UK (celebrating its 50^th anniversary this year), I can only imagine Cicely Saunders would be delighted to see the pictures and information that has been shared on Facebook, Twitter and Instagram, just to name a few. 

Social media has a reach in every city, state, and country in our world and we encourage you to keep the hashtags #Hospice, #PalliativeCare, #hpm in your posts. Here are a few tips that could also be  of help when creating shareable content for hospice and palliative care throughout the year:

• Concentrate on Increasing Daily Posts and Updates
  -  Ensuring that your posts and updates have a good chance to be seen by your target audience is an integral part of a content strategy.
• Share Content More Than Once
• Gain more traffic, reaching people in different time zones and sharing content with people who’ve followed you since your last post. 
• Keep an eye on NHPCO’s Caringinfo.org and MomentsOfLife.org for resources added throughout the year. 
• Create Google alerts for “hospice” and “palliative care.”
  -  Share news stories about the community that would be of interest to your followers.

We thank you for taking part in #HospiceMonth and for raising #HospiceAwareness. We hope you continue to add to the ‘wave’ you have created on social media!

A gift to those you love: this Thanksgiving talk about the care you would want

NHPCO is encouraging families to spend time when they may be gathered for the holidays, to talk about the care they would or would not want. This is particularly important if a family is coping with a serious or life-limiting illness of a loved one. Having discussions about one’s health care wishes is part of advance care planning.

Advance care planning involves making decisions about the care you would want to receive in a medical crisis that might be the result of a serious illness or an unexpected accident. Advance care planning also involves deciding who will speak for you if you are not able to speak for yourself.

An essential part of advance care planning involves having these important conversations with your loved ones. Advance care planning also includes:

• Deciding what types of treatment you would or would not want should you be diagnosed with a life-limiting illness or faced with a serious medical crisis.
• Sharing your personal values and beliefs with your loved ones.
•  Completing an advance directive to put into writing what types of treatment you would or would not want.
• Designating a person as your health care power of attorney (sometimes called a health care proxy) to speak for you if you cannot speak for yourself.

“During the holiday season, families are often gathered together and that can be an ideal time to have caring conversations with loved ones about wishes and priorities for the future," said Edo Banach, NHPCO president and CEO. "This is one of the most important gifts we can give to our families and loved ones."

NHPCO’s CaringInfo.org offers free state-specific advance directive forms and free information to help families talk about the care they would want. Visit caringinfo.org/planningahead.

NHPCO offers a video that looks at issues involved in advance care planning.

Palliative Care: Comfort and Hope for People Dealing With Serious Illness

Palliative care, sometimes referred to as “comfort care,” is a specialized approach to the treatment of patients with a serious or life-threatening illness. The National Hospice and Palliative Care Organization has released a new video to help the public understand more about palliative care and the many benefits it can provide. In the video, Michael Sampair talks about his experience with palliative care and being treated by the palliative care medical team at The Elizabeth Hospice in San Diego, California.

The goal of palliative care is to provide relief from the symptoms, pain and stress of serious illness. It is also designed to improve the quality of life of both the patient and the patient’s family caregivers. What sets palliative care apart from hospice is that patients can continue to receive aggressive and curative-focused treatment like chemotherapy, radiation, dialysis and surgery while receiving palliative care. Palliative care brings another layer of support that often is missing in conventional medical care delivery.

“When patients don't have pain under control, it's hard for them to really enjoy life and to live life to the fullest and he was really finding he had a lot of life still to live but he wasn't able to enjoy it or to be fulfilled because of the pain,” says George Delgado, MD, FAAFP, HMDC, and Chief Medical Officer at The Elizabeth Hospice who worked with Michael to get his pain under control and manage his other symptoms which included insomnia and nausea.

Michael’s quality of life improved with proper symptom management and emotional support and he was able to make a trip to Minneapolis to see his family.

In the video, Michael explains that palliative care has helped in many ways. It allowed him to receive care at home versus traveling to the doctor. “People like me, we don't want to be in doctor's offices and hospitals,” he says. “So when they come and they visit you at home, that's special. That’s unexpected.”

Palliative care helped Michael Sampair achieve a better quality of life. 

“The philosophy of palliative care is the same as with hospice –patient-centered care that addresses the medical, psycho-social and spiritual needs of the person and family caregivers,” says NHPCO President and CEO Edo Banach. “Many hospice programs across the country have implemented community-based palliative care programs into the services they offer.” 

To learn more about palliative care, visit momentsoflife.org/palliativecare or download a palliative care listicle that highlights some of the most common questions asked about palliative care.

Kristallnacht

November 9 is Kristallnacht, the unfortunate anniversary of the anti-Jewish violence that took place Germany on November 9 and 10, 1938.  I had the honor of spending the day with MJHS in New York City. We visited the Museum of Jewish Heritage and discussed the future of hospice and palliative care. I capped the day by meeting with an MJHS Interdisciplinary Team.

 

While certainly an emotional day, I ride the rails back home feeling good about the state of our field. Good trauma-informed care comes from a place of person-centeredness and understanding. We have so much trauma to care for these days—as we always have—but what gives me great hope is what we have learned as a community about how to deliver interdisciplinary, person-centered care. 

What I saw in the Interdisciplinary Committee room was a rare (for health care) display of real coordinated care, shared among different disciplines, with the patient and loved ones in the middle. This should be the rule, not the exception in health care.

I had never reflected upon—until today—the fact that both of holocaust-survivor grandparents died under hospice care. My grandfather was reserved, wounded on the inside but never sharing.  He died of Alzheimer’s disease.  My grandmother was outgoing, and demanded to visit Auschwitz (which she survived) before she died of cancer. She made it. Both my grandparents experienced incredible trauma, but came out of it in very different ways.  It was not until they were cared for by the hospice interdisciplinary team that anybody really bothered to tend to the full range of needs they each had after living a full life.

So, here’s to hospice. I wish we were not needed, that there was no death or struggle in life. But so long as there is, I could not think of a better system to care for our struggling brothers and sisters. 

Edo

Edo Banach, JD
President and CEO
NHPCO

Thoughts on Recent Tragedy in Texas

A Message from Edo Banach

News broke this weekend of another mass shooting in the U.S.  This time, in the south Texas town of Sutherland Springs. In terms of casualties, it is the worst shooting in the history of Texas. Yet, what makes this even more disturbing is that it took place in a church.  How does one respond to another breaking news story of this kind? As a nation, we have seen such violent acts in California, Colorado, Connecticut, Florida, Nevada, Ohio… tragedies seem too numerous to mention.  

Is it possible to become numb from such tragedies? Do we ever become too weary, too overwhelmed, too disinterested when we learn of such a horrible incident?  I hope we do not.  

The shooting this Sunday resonates in a troubling way due to the circumstances of the location – families worshiping together in what is a sacred space. But whether such a tragedy occurs in a school, office, nightclub, concert venue, shopping mall…or a church, synagogue or mosque, we respond in shock, fear, anger or dismay.

As the hospice and palliative care provider community, I know that many of you will be tending to a family who will be experiencing a significant loss today, tomorrow or the next day – that of a loved one under your care in hospice. We are a professional community that deals with death on a daily basis; many providers are skilled at helping communities respond to public tragedies. Yet, we know that not even one single death can ever be considered routine. We know how loss and grief impacts individuals and the broader community. In some ways, it is this deeper understanding of loss that allows us to recognize and identify with those who grieve, for whatever reason. And our reactions to events such as Sunday’s shooting can affect us in different ways – but never indifference.

I think a significant part of the work we do with patients and families involves the skill of listening...listening to people sharing fear, sadness and love for what is lost or changing. As we respond to news of this weekend’s tragedy, let us remember the importance of listening with a compassionate ear to our families, our coworkers, our neighbors and those strangers whose lives we intersect.  Let us hold onto the compassion and caring that grounds us so strongly in our professional lives and may sustain us in our personal lives. Let us be ennobled by the strength we have and that we share with others and let us not be embittered.

 Let us also remember, and remind others, that we are often called upon to do much more than to care for hospice patients.  Our value runs deep in the communities we serve, and we are needed more than ever.  

Thank you for the work that you do. 

Edo

Edo Banach, JD
President and CEO

National Hospice and Palliative Care Organization

November is National Hospice and Palliative Care Month

NHPCO Leading Outreach Efforts throughout November to Help People Understand that “It’s about how you live!”

This month, the National Hospice and Palliative Care Organization is working with hundreds of hospice programs across the country to raise awareness about hospice and palliative care.  November is National Hospice and Palliative Care Month and this year’s theme is “It’s about how you live!” 

Hospice is not a place, but rather a model of high-quality care that enables patients and families to focus on living as fully as possible despite a life-limiting illness. Palliative care brings this holistic model of care to people earlier in the course of a serious illness. Hospice organizations are among the largest providers of community-based palliative care services in the nation.

“Every year, nearly 1.5 million people living with a life-limiting illness receive care from hospices in this country,” said Edo Banach, president and CEO of the National Hospice and Palliative Care Organization. “These highly-trained professionals ensure that patients and families find dignity, respect, and love during one of life’s most difficult journeys – it’s really about living.”

Hospice and palliative care programs provide pain management, symptom control, psychosocial support, and spiritual care to patients and their families when a cure is not possible.

As part of national outreach efforts, NHPCO is sponsoring a hospice and palliative care Social Media Push on Friday, November 3. This annual event was created to share positive and informational messages about end-of-life care via social media. All supporters and advocates are encouraged to participate using the hashtag #hospiceawareness.

"One of the most common regrets we hear from hospice patients and their families is that they delayed the decision to take advantage of hospice care,” noted Banach.

To learn more about hospice, palliative care, advance care planning, or to find a hospice provider in your community, visit NHPCO’s CaringInfo.org.

 

Music Therapy Helps Hospice Patients and Families

The National Hospice and Palliative Care Organization has released a new video that highlights the use of music therapy in hospice care. “Mr. Gregg: the Life of the Party” follows Robert Gregg, a Seasons Hospice and Palliative Care patient, suffering from memory loss and agitation due to advanced illness. Music therapy has helped restore some of the lighter and more cheerful aspects of Mr. Gregg’s personality and has been a positive addition to his care.

Music therapy was introduced into Mr. Gregg’s care after a hospice aide realized he was responding positively to the songs she would sing to him. Sara Harris, Board Certified Music Therapist at Seasons Hospice and Palliative Care, was brought in to Mr. Gregg’s home to provide music therapy sessions. She offers a reassuring tempo that allows Mr. Gregg to adjust his breathing to sustain both happiness and peace. In the video, Mr. Gregg sings along with Sara, claps his hands, and has a broad smile on his face.   

Jackie Gregg, Mr. Gregg’s wife, was unsure at first how music therapy would help him. But once Sara started playing her guitar, she noticed Mr. Gregg moving his shoulders and toes. He seemed very happy.

Music bridges a gap between their reality and our reality,” says Harris. “And for families who may have not seen their loved ones speak or sing or anything the past few years, it’s just absolutely priceless."

"As a musician, I believe in the power of music to transcend words and connect people,” says NHPCO President and CEO Edo Banach. “Music therapists help provide physical and emotional peace to patients and families at the end of life."

Mr. Gregg’s video is part of the Moments of Life: Made Possible by Hospice public awareness campaign launched by the National Hospice and Palliative Care Organization in 2014. The campaign features stories from hospices and palliative care programs across the United States of patients and families experiencing hospice and palliative care first hand. Moments of Life was created to help people understand that hospice and palliative care help patients and family caregivers live as fully as possible despite serious and life-limiting illness. Visit MomentsOfLife.org to learn more.

 

The Many Reasons That I Celebrate Front-line Caregivers

by Katherine Murray, RN, BSN, CHPCN(C).
Shared courtesy of Life & Death Matters Blog.

October is the month to celebrate personal support workersin several provinces in Canada. In the US, the contributions of hospice aides and certified nursing assistants are celebrated in November.

At Life and Death Matters, we join with health care teams and members of the public across North America to celebrate and give thanks to the incredible people who serve in these caregiving roles. I would like to take a few moments to talk about the many reasons to celebrate front-line health care workers.

I have interviewed hospice aides over the past month as I prepare for an NHPCO webinar series for hospice aides. Several interviews had to be postponed as the hospice aides evacuated people before Hurricane Irma hit Florida, or when wildfires spread in California. Another time the call needed to be rescheduled because the hospice aide was working in a remote area without cell phone reception. In the interviews I repeatedly heard stories of connections between the hospice aide and the person and family, stories of caring, stories about letters written by bereaved family members that expressed gratitude for the personalized support, and the ability of the hospice aide to adapt care to best meet the needs of the person and the family. These examples reinforce for me that front-line caregivers are pillars of support that the person, family, and health care team can depend upon.

I wrote a blog post about a study of the experiences of front-line caregivers in Ireland. I was delighted to hear stories that showcased similar experiences of hospice aides in the USA. Hospice aides, in their rather straightforward manner, shared a few stories and examples of how they work with the person and with the team. For example, I’ve heard repeatedly about a time when a hospice aide shared their concern about a person they were assigned to. How they formulated a report that shared their observations, the questions they asked, and then called the nurse supervisor. In each case, the nurse responded in a short period of time, and followed up on the hospice aide’s concerns by contacting the appropriate member of the team. In one case, the nurse called the physician to report pain and request an increase in pain medication. The nurse supervisor also visited the person when necessary.

"In each story, the hospice aide initiated changes in care,
and then adapted their care to best meet the needs of the person."

These stories and reports of events impressed me.

In the past weeks I have talked with several directors of care and nurse leaders at hospice organizations in California. In each hospice, the hospice aides were invited and contributed to interdisciplinary team meetings, and participated in education. For some hospices, the meetings occurred by teleconference, with members of smaller teams meeting at set times each week. For other hospices, the ENTIRE team gathered in one room, where deaths were reviewed, “what went well” was discussed, thank-you cards were read, cases were reviewed and care plans updated, and attendees were educated in the moment. I was impressed! The hospice aides participated alongside the physician, nurses, social workers, counselors, and therapists. These front-line caregivers are valued for their commitment, their caregiving, and are fully accepted members of the health care team.

Following this meeting I interviewed two hospice aides. In one interview, Terry, who previously worked with oil pipelines as well as other physically demanding jobs, shared with me about coming to hospice later in life. It is her quote that appears at the beginning of this posting,

"Singers sing, painters paint, and I am a hospice aide and I care.
I love it. It is what I do… It is what I have to do."

To all those front-line health care workers, whatever your title, THANK YOU for caring. Thank you for the work you do. You are incredible! Your work is valuable.

Thank you. 

-###-

 Learn more about NHPCO's educational program, the Hospice Aide Webinar Series, taught by Katherine Murray, RN, BSN, CHPCN(C). The series features three webinars offering the first three Wednesdays in November and includes MP4s and resources for your library. This is a cost-effect way to offer professional development created especially for hospice aides.

CMS Recruiting for Hospice Quality HEART Tool Pilot

CMS has contracted with RTI International to develop the Hospice Evaluation & Assessment Reporting Tool (HEART), an expanded item set covering the comprehensive patient assessment for hospice providers.  As part of the HEART development process, RTI will be pilot testing the draft HEART instrument by conducting two sequential pilot tests.  

RTI is currently accepting applications to participate in the pilot test for HEART

The deadline for applications is October 31, 2017.

How to apply to participate in the pilot:

If you are interested in participating, please complete the pilot interest form located in the download section of the HQRP Requirements and Best Practices tab on the HQRP website and email it to hospice@rti.org by October 31, 2017. The project team will contact you to further discuss the pilot project. If you have questions about the pilot, please contact Jennifer Tierney Lyden at 919-541-7447 or at jlyden@rti.org.

Read the complete Hospice Evaluation & Assessment Reporting Tool (HEART) Pilot Project Overview.

Palliative Care and Hospice Organizations Collaborate to Advance the Field

The National Coalition for Hospice and Palliative Care: Working together to coordinate, communicate, and collaborate on advocacy, quality, and beyond.

What is the Coalition? Why is it Important?

Welcome to the first blog post from our Coalition. If you have attended a hospice or palliative care conference in the last few years, it is likely that you have heard the proverb, “If you want to go fast, go alone. If you want to go farther, go together.” The National Coalition for Hospice and Palliative Care (also referred to as the Coalition) is a critical mechanism for ensuring that the field goes far. Originally established by four organizations in 2002 to create a foundation for defining quality palliative care, i.e., National Consensus Project, Clinical Practice Guidelines for Quality Palliative Care, the Coalition is now comprised of nine national organizations representing clinicians from the full interdisciplinary team (physicians, nurses, social workers, chaplains, and physician assistants), researchers, and hospice and palliative care programs. The Coalition’s goals focus on four essential elements, the “Four C’s”: Cooperation, Communication, Coordination, and Collaboration.

These nine hospice and palliative care organizations work independently to improve quality of life for seriously ill patients by addressing the needs of their constituencies in areas such as education, advocacy, quality improvement, research, etc. While each has been incredibly effective on its own, the field as a whole faces many challenges:

• Rapid evolution of health care and health policy in the U.S.; 
• Rapid increase in the number of people who would benefit from palliative care and/or hospice services; 
• Rapid proliferation of new interventions/initiatives designed to address the high-need, high-cost populations (some with the patient     and family in mind, some with cost savings in mind), creating much “noise” around the right way to care for these patients; 
• Continued misconceptions about what hospice and palliative care can offer and who is eligible for these services; and 
• Limited resources in our small field.
  

Using the Four C’s, the Coalition helps the field proactively address these challenges by convening representatives monthly from each organization to strategize on key public policy challenges; improve communication to avoid duplication of effort where possible; and share intellectual resources. We work together to respond to legislative and regulatory opportunities, and are structured to nimbly respond to significant opportunities and threats (e.g., the recent misrepresentation of palliative care by a U.S. Senator). However, the most important function of the Coalition is to initiate and strengthen relationships across the field. As a result of the Coalition, members often feel more comfortable reaching out to each other individually as needed to clarify an issue, brainstorm ideas, and collaborate on new initiatives. By finding natural opportunities to work together, we strengthen each other and increase our impact – both within the field and to external audiences.

Our next post will describe the Coalition’s structure and its core activities and accomplishments. In the meantime, check out the Coalition’s new website where you can find more information about the work of our Coalition.

Blog Contributors:

Amy Melnick, MPA
Executive Director, National Coalition for Hospice and Palliative Care

Stacie Sinclair, MPP, LBSW
Senior Policy Manager, Center to Advance Palliative Care

This is the inaugural blog in a series from the National Coalition. 

Impactful Relationships and Hospice

Have you ever thought about how the relationships in your life have affected you? Maybe some meant more than others; or some left an impression that stuck with you…

With growing technological advances, relationships in healthcare can exist among providers and patients without ever setting foot in the same room. Relationships in healthcare have long been viewed as a critical factor to the quality of care provided and nowhere has this been more evident than in the hospice community. The wider medical community is learning that relationships have the ability to affect a person’s physical health along with emotional health. There are plenty of studies that suggest being alone at the end-of-life increases mortality among older adults.  There is data measuring quality in relationships and the affect it has on heart health. These results matter. If there were ever a time to have quality relationships, ones where you and your family felt heard and supported, wouldn’t you want it to be at a time like the end of your life?

For more than four decades, hospice and palliative care interdisciplinary teams have fostered deep relationships with the patients and families they care for, and now this understanding is growing to the broader medical community.  As developed by Dame Cicely Saunders fifty years ago and outlined in the Medicare hospice benefit for 35 years, the team approach to care for dying persons includes a physician, nurse, home health aide, social worker, spiritual care providers, allied therapists, bereavement counselors and volunteers. Hospice has shown how members of the interdisciplinary team work together to care for a patient and provide support to the patient’s family that continues even after their loved one has died. The IDT approach allows these relationships to be built with the patient and family in their home, hospital or care facility.  With a desire to explore just how unique and meaningful these relationships can be, NHPCO directed the annual creative arts contest with relationships in mind.

Guided by only a theme – “Impactful Relationships: The Interactions of Hospice and Palliative Care,” members of hospice and palliative care interdisciplinary teams from all over the US sent in over 70 submissions consisting of photos, blogs and poems. These ‘works of art’ tell a story. They are inspirational and offer an opportunity to explore the lives of people working in hospice, the work they do, and the patients that are near the end of their lives. We invite you take a peek at the winning submissions for “NHPCO’s 2017 Creative Arts Contest” and explore for yourself the ‘impactful relationships’ that exist within hospice and palliative care.

By Elizabeth Schneider
NHPCO

Tragedy in Las Vegas - A Message from Edo Banach

We join a heartbroken nation responding to the tragic shooting in Las Vegas.  While no team members of programs that we have spoken with were killed in the shooting, there are a number of hospice staff who have friends and neighbors who were injured and killed. Our thoughts are with them.  As hospice professionals, we know that grief and loss are a part of life.  But there’s something uniquely tragic about loss that stems from blatant disregard for human dignity.  No matter what our political leanings, religious beliefs or social philosophy, I think we can all agree that there is no place for such senseless violence in our society.  

Communities often lean on the support and expertise that hospice can offer when tragedies involving loss of life occur. We have heard countless stories of hospice bereavement counselors going above and beyond their everyday job duties in times of need - from rushing to a school after a car accident that claimed a young life, to offering grief support to a local business that experienced the unexpected loss of a beloved colleague, to opening its doors for grief support groups that are developed in response to a community’s unique needs.  So far, we know that Nathan Adelson Hospice has set up a hotline for community partners to call if they need help or support. Infinity Hospice Care sent credentialed staff to UMC Trauma Center the night of the shooting and they helped the overwhelmed hospital staff by serving food to keep them going. Community organizations are gathering in Las Vegas today to organize and assess available resources and individuals who can work together to address the many needs that will arise in the coming days. I am certain the Las Vegas hospice community will be going above and beyond to help those who were affected by this horrific tragedy. 

But there is more we can do. If we are ever to move beyond simple “thoughts and prayers,” we are going to have to come together as a country.  And the hospice community is uniquely positioned to help us do that.  Not just by providing grief counseling – which we will most certainly do – but by modeling how even the most vexing, challenging problems can be managed when people come together. By demonstrating how a team is strengthened when it includes a diversity of perspectives.  By embracing a philosophy that is rooted in dignity, respect and compassion.  Indeed, our nation’s leaders could learn a thing or two from the hospice movement.   

In the coming months, I’m going to be talking more about how hospice and palliative care professionals can be leaders in helping America cope with its many challenges.  I hope you all will be a part of that conversation. Until then, thank you for the work that you do every day.

By Edo Banach
President and CEO
NHPCO

Read Past the Headline

Despite an unfortunate and misleading headline that appeared in Politico yesterday, “Hospice in crisis,” the article is actually a thoughtful look at what we as a provider community face in caring for people at the end of life. For those who may have seen this headline in your news tracking or social media feeds, I’m sure you were immediately concerned, as was I. However, I encourage you to read past the headline.

The article explores how demographic, competitive and public policy changes are challenging the hospice industry. The author Joanne Kenen – who NHPCO spoke with for her reporting – is not pointing an accusatory finger towards hospice, but is instead exploring the changing environment in which we must provide care.  (As an aside, it should be noted that Kenen did not write the headline, that was done by editorial staff at Politico.)    

A better headline would have been “Hospices Navigate Changing Environment.”  Unfortunately, crisis sells and our challenges do not.  

While it is true that hospices are challenged by changing demographics and patient needs, the crisis is most acutely felt by patients and their families. As providers, we know that when people wait until they are actively dying to access hospice, our patients and family caregivers are unable to fully utilize and benefit from the wide range of services that we provide.  Those of you on the frontlines know this best.

Part of our job is to innovate while we continue doing what we already do so very well. NHPCO is eager to work with Congress, the Administration and other stakeholders to enact policy changes that allow patients to receive palliative care earlier, expand access to concurrent hospice care, and support the delivery of other services that improve care for individuals with serious and advanced illness near and at the end-of-life.  

In fact, we are supporting legislation that our affiliate the Hospice Action Network is championing on Capitol Hill that would likely help more Americans access quality hospice care in a timelier fashion. If you are not familiar with our two major legislative priorities, the Patient Choice and Quality Care Act and the Rural Access to Hospice Act, I hope you’ll visit  the links to learn more on the HAN website.

We are pleased that Kenen took the time to interview me as part of her research and I trust this conversation will be ongoing.  We had a thorough conversation about the realities of caring for the dying, which we are encouraged could lead to additional reporting on the important work NHPCO is doing on behalf of the hospice community.

Thank you for your continued work towards providing high quality care to an ever increasingly complex population in an evolving health care landscape. I can attest to the amazing work I have seen firsthand from one corner of the country to the other and I am proud of the dedication, compassion and understanding I see among the hospice community to adapt to the world around us.

By Edo Banach

President and CEO