James M. Berklan, Editor

When it comes to running a business, you better evolve. If you don’t, trouble will surely find you. Maybe it will even if you do.

Consider a recent report critical of nursing homes’ hospice care practices. In brief, it said that nursing homes have increasingly figured out how to make a decent profit from hospice services. That, combined with the aggressive hospice growth strategies some providers have adopted, is apparently smoking gun enough to accuse providers of wrongdoing.

Some critics have gone as far as to call for the elimination of payments for hospice care in nursing homes. Others seem to simply take the position that if there’s money being made, it’s time to get a piece of the pie, too. That goes for providers jumping on the bandwagon and regulators interested in balancing budgets.

It’s a classic riff on the line from noted Chicago thief Willie Sutton. When asked why he robbed banks, he replied matter-of-factly: “Because that’s where the money is.”

We’ve seen it happen many times before. Authorities, sensing something must be wrong if long-term care providers show a little prosperity, yank the reins on some funding stream. The rehab realm is the most obvious recent example.

The script goes like this: Officials create a set of new rules or payment reimbursement criteria; providers figure out how to capitalize on them; authorities need to hold down payouts overall so they go after whoever looks like they’ve been making a buck.

That’s what you get when your lifeline is government funding. Uncle Sam giveth, Uncle Sam taketh away.

There will be more smoke and fire over the hospice numbers, but entanglements will ensure the business model won’t change much in the near future. The major nursing home chains wouldn’t be ramping up hospice efforts the way they are if they seriously thought the bottom would drop out.

There will be tweakings and “corrections” to reimbursement levels but not enough to drive nursing homes away. Adjustments will come as government officials continue their bipartisan tidal wave to fund more home- and community-based services.

Hospice’s mission of easing pain and bringing quality of life will continue unabated—for needy individuals, and providers’ bottom lines alike.