Hospice agencies come in all sizes and shapes, just as hospice care does. When beginning the process of choosing a hospice provider, you may notice companies will make claims such as “non-profit, leading provider, largest provider, independent provider” and more to describe why they are the best option. It is important to know that none of these claims automatically signify that one provider is better than the other, but that they are indicators of how each agency runs their facility and services.
Non-profit and for-profit models are surprisingly similar for how much the distinction is pushed as an important factor in the decision making process of a hospice service provider. 90% of recipients of hospice patients receive care under the Medicare benefit, regardless of whether they received care from a for-profit or non-profit agency. This means that physician services, nursing care, and medications specific to pain management, social work services, spiritual care, volunteer participation, bereavement services, and more are all covered by the Hospice Medicare benefit. Both models often accept donations and recruit volunteers to supplement the services provided by Medicare in order to do special activities etc. outside of what is required as a baseline.Perhaps the largest distinction between the two is that non-profits do not pay taxes, however both must pay their employees. The tax money from for-profit providers is given to the county for community programs that many of these facilities use as resources for their patients.
Larger providers typically have larger facilities that can house more patients. These facilities will generally also therefore have a more substantial donation pool to pull from as well as a larger staff. A larger facility and staff also suggests that they must provide care to a larger patient base. Because of this, care teams are often not able to spend as much quality time with each patient. This can also mean that teams are rotated and continuity of care is sometimes sacrificed to maintain numbers. Continuity of care is a major factor that can impact the assuring of comfort and dignity of the patient, as smaller signs might be more significant to a nurse etc who has been caring for a patient steadily for months. Beyond this, larger providers or larger hospital systems that offer hospice services will often partner up with other agencies that already have a built-up contracting force in order to avoid taking on the responsibility themselves. This is cost and time effective for the hospital, but does not say as much for the quality and attention to detail of care.
Smaller facility care teams on the other hand have smaller staff to patient ratios which allows them to take more time devoted to each patient. Smaller facilities and providers are more likely to have a care team devoted strictly to each patient that does not rotate or change throughout the hospice process, which allows deeper bonds to be formed between the team and the patient. This also increases the chances that patient’s are looked at as people rather than numbers, which can have an extremely meaningful impact in the type of care that is received. Smaller providers are therefore also more likely to be willing to think outside of the box. Hospice is a philosophy of care, which means that sometimes what a patient needs can be found much more readily on a baseball field than in an IV. Smaller providers are more likely able to grant special requests like this as they can manage the risk more effectively.
So which type of hospice provider is best? Well, that depends heavily on you or your loved one’s unique needs. The truth is that each patient’s situation is different. At the end of the day, asking questions is the only way to truly know which hospice care center or service is right for you or your loved one.
