Editor's Desk: Nowhere near final word for best hospice settings

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James M. Berklan, Editor
James M. Berklan, Editor

I'm glad to say there isn't too much that flies under the radar here when it comes to the big issues in long-term care. That's one of the reasons you have us in your hands right now.

It's also why when we do experience a surprise, it's usually mild. But I have to admit I wasn't really ready for the outpouring we received over one of our recent reports. It undoubtedly struck a raw nerve with you and your colleagues.

Sure, you're concerned about whether your Medicare payments will be getting slashed or whether there will be new requirements for wound care. But neither is the topic I'm referring to.

What generated so much discussion has been hospice care. Though nothing new to nursing homes, hospice services are booming at long-term care facilities. Government researchers note as much in a new report (see page 14).

The only problem is, government investigators also say a vast majority–as in 82%!–of hospice care taking place in your facilities doesn't fall under Medicare reimbursement requirements. Now that's water-cooler fodder.

After the article appeared, readers immediately began registering opinions on our Web site (www.mcknights.com – just search under “hospice services” to find the Sept. 11 piece). The discussion has been provocative but entirely respectful, and educational. You're a good crowd.

But you can't make up your collective mind as to the value or propriety of hospice care in your facilities.

While many believe hospice just adds another level of bureaucracy and is a poor use of tax dollars, others maintain there might not be a better place for someone nearing the end of life.

Among the other interesting points you've made: If long-term care facilities are suffering nurse and various other caregiver shortages, how can they give adequate attention to hospice patients? Some are certain it can't be done, while others say, ‘Hogwash, it's been done for years.'

Perhaps one of the most salient points brought up is that hospice care is usually provided by an outside agency, not nursing home staff. Does that mean the facility is more insulated from risk, or, on the contrary, could its reputation be more at risk?

The debate continues, as well it should.

And as long as it does, the education of readers–and writers and editors–will continue as well.

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