Hospice Advisors Case Study
Title: The House Hospice
Company: Several Hospices Around the COuntry
Date: February 12, 2015
Problem: A Hospice House losing large amounts of money!
Presenting Issues/Challenges: I am working with several hospice companies that have “Hospice Houses” and all have the problem of financial viability. Here is one case that reflects all the others. A 14-bed free-standing hospice house to care for hospice patients, despite their level of care needs. In this specific case, the feasibility stated that unless a GIP census of 7 per days was maintained, the facility would lose money. The GIP census was 2 ADC with an overall ADC of 9. The annualized lost was $450,000. There was not a formalized plan in place to drive GIP business into the facility. The charity dollars that were used to help support the Hospice House were declining.
Plan of Action: The growth plan for this Hospice House was part of an overall growth plan for the hospice organization. Following are some of the salient action steps taken:
1. Change the Mind Set
We started to take about the Hospice House as an Inpatient Hospice Unit (IPU) and not a residential home for hospice patients.
2. Level of Care Management
The hospice did a great job of taking care of patients who had break-through issues on the pain and symptom side. Some of these patients would have been eligible to access the GIP level of care. Instead, the nurse takes excellent care of the patient and the hospice just doesn’t get credit or reimbursed at the correct level for the care. A process was put in place to evaluate every patients’ level of care appropriateness and make adjustments as needed.
3. Nurse Liaison Program
We implemented a Nurse Liaison Program at two hospitals that were within a 5 mile radius of the facility. These Liaisons became a valuable tool to both assist the hospital with key challenges while assisting admit patient to the facility for GIP care.
We started a GIP program strategy by engaging a hospitalist in each hospital where we had a Nurse Liaison Program to build and execute our GIP Programming at each hospitals. For example, Emergency Department Hospice Diversion Program, Hospice Grand Rounds, GIP Scatter Beds (we would do GIP in the hospital if the patient could not be transferred), etc.
5. Leased Beds
We open the facility to let other hospice lease our beds/services to help build volume. We charged 85% of the GIP Medicare payment rate.
Six months into the implementation the following were noted:
- The GIP Average Daily Census grew to 6 from 2.
- During this period, we had 19 GIP admissions from other hospices which generated $42,750 in revenue.
- The projected financial results are to be Break-Even after 12 months.
- Projected ADC for year two of plan implementation is an ADC of 9 GIP patients and a net profit being generated.