Post Squares 12.27.13 ~ Chocolate Is Not Dying

Post Squares 12.27.13 ~ Chocolate Is Not Dying

According to a Washington Post investigation, hospice is turning into something much different from its original concept.

When hospice began, the programs that helped terminally ill patients and their families, were started and run by religious and community organizations. Beginning in 1983, Medicare started paying for hospice care.

As more Americans turned to hospice, big business saw an opportunity to make money. Today, for-profits dominate the industry.

Medicare pays about $150 a day, whether or not a patient receives care. If the hospice doesn’t need to pay for a visit from a nurse or aide, it pockets that daily allotment. The short-stay patient, one who is admitted in the last days of life, is not as profitable to the hospice company as a patient who lives for a longer time. That’s because upon first enrollment there are costs for diagnostic procedures, the set up of equipment at home and, typically, more visits as life is ending. The patient who is there for longer stretches of time, when no care is needed, yields more profit for the hospice company.

Some hospice workers, after seeing patients being brought into the system who were not dying, but being used to generate income for the companies, have quit their jobs and are bringing allegations against their former employers. They report being pressured to recruit people who they felt did not belong in hospice care. One executive tells of being penalized for not meeting a quota of enrollments, while another was given a massage chair for bringing in the most hospice patients.

The large for-profit businesses under attack deny the accusations and have lists of excuses and explanations for the remarkable differences in their earnings compared to the non-profits.

Medicare does have a cap on how much they will pay the hospices per patient. When this limited is reached, it is reported that the companies “dump” the individual, citing reasons of ineligibility.

This was the case for Chocolate Blount, 91, the man featured in this cover story. He was receiving in-home care by one of the big, for-profit companies under question. After about a year the company told his family he was “doing so good” he was no longer to be provided the hospice help upon which they had come to depend.

This 4” square colored pencil drawing is taken from a detail of Mr. Blount’s wheelchair. I didn’t color carefully in the lines, as I usually do. I scribbled the color into the general area of each section, and scribbled over the whole thing with a white pencil, making it look somewhat like a weaving. It has been turned up-side-down from the way it was first drawn.