James M. Berklan

Welcome to the club.

That’s the sad but apropos message I have for our hospice-operating friends.

As we note in our Daily Update news item today, hospice operators have been put on the hotseat. In a first-of-its kind (but surely not the last) national report, the Office of Inspector General skewers many hospice providers for falling short in their duties of care.

Clearly, not all are guilty of alleged shortcomings. But by bringing the sector into the negative spotlight, all members have been spattered, even if only by association.

Sound familiar, nursing home operators?

Some might argue that seeing 87% of hospice operators tripping up at least once over a four-year span is a shrug-your-shoulders statistic. Who wouldn’t mess up over a nearly 1,500-day span? It’s the 1 in 5 (about 20%) who had serious enough lapses to endanger patients that will raise significant eyebrows.

The implications for hospice operators are ominous. Once a watchdog sniffs you out, it tends to return often, like an over-active puppy. Even if you throw the ball in a different direction each time, the dog will chase it down, bring it back and be ready for more.

This (watch)dog is clearly eager to “play” some more.

In skilled nursing, family members may saddle operators with wide-ranging, often unrealistic, expectations. But there are more modest presumptions from hospice clients and their families. Show up. Give support. Make it comfortable. Provide for a good ending. (The fact that there’s patient and family acknowledgement that an end is coming is a lift many skilled nursing operators wish they had.)

The relative simplicity of hospice goals can be a double-edged sword. Screw up these straightforward requests and needs, and families and government agencies will come down hard. That death is coming is bad enough: They expect you to get it right.

The Centers for Medicare & Medicaid Services currently doesn’t post all of the revealing information it might have about a hospice on its Hospice Compare website. Also, CMS also doesn’t have legal authority to assess fines.

It might not happen overnight, but expect both of those circumstances to change. With hospice use growing in popularity, expect the heat to intensify.

The dues are high in this club, and sometimes you’re a member whether you like it or not. Just ask the nursing home crowd.

Follow Executive Editor James M. Berklan @JimBerklan.