Patient Referral

Hospice data looks at time spent with patients

By Jena Sauber

St. Joseph News-Press

Choosing a hospice care provider can be a multi-faceted decision during a potentially stressful time, but the Centers for Medicare and Medicaid Services are working to help make the decision easier for patients and their families.

“The ultimate goal is to measure all agencies on the same playing field just to ensure not only CMS, but also consumers, that they are comparing apples to apples when they are selecting providers for whatever their health care service is,” said Ryana Parks-Shaw, team leader with Mosaic Life Care Hospice and Palliative Care.

The Centers for Medicare and Medicaid Services Chronic Conditions Data Warehouse has compiled national CMS Medicare and Medicaid data on hospice providers to help providers and consumers identify areas for improving care quality, ways to reduce program spending and information for research across different studies and populations.

The data includes time spent with hospice patients daily and time spent with patients in their last seven days of life.

Crossroads Hospice & Palliative Care, which serves the St. Joseph area from its Kansas City, Missouri office, evaluated 23 multi-state hospice organizations with a patient census of at least 500 people, according to the CMS data. Mosaic’s hospice program was not included in the analysis.

They found that the overall time spent with each hospice patient by those organizations was an average of .635 hours, or about 40 minutes, per day. In the last seven days of life, that number decreased to .587 hours per day, said Perry Farmer, president of Crossroads.

Crossroads reported a daily average of .802 hours, or about 50 minutes, and an average of 1.372 hours, or an hour and 20 minutes, per day in the last seven days of life. The organization focuses on providing longer visits and attending deaths when possible, Farmer said.

“I’ve seen two studies that said that about 1 in 4 or 1 in 5 deaths were attended by hospice,” Farmer said. “Early on, our stake was that we were going to start holding our sites to a standard of 80 percent, which is extremely difficult. It intensified our programs. If we are there on a daily basis, which is already above the norm, we are able to spot that death was imminent.”

Mosaic Hospice providers spend an average of 60 minutes per person at each visit, Parks-Shaw said. The hospice averages approximately 115 patients at one time.

Kelly Ruckman, registered nurse case manager with Mosaic Hospice, sees between four to six patients a day, averaging 45 minutes to an hour at each location, she said.

On Friday morning, she visited Bill and Katherine Chellew of St. Joseph. Bill Chellew has received hospice care since he experienced congestive heart failure in March 2016, and Ruckman has provided care for the couple for more than a year.

“You definitely build relationships while you are here for that long. That is very important to me,” Ruckman said. “We get really close to our patients. It’s nice to be able to sit down and spend time with your patient. You get to build those relationships with the patient and with the family so you aren’t just running in and out quickly.”

A consumer-oriented Hospice Compare website using CMS data is expected to be unveiled in 2017, Parks-Shaw said. Similar CMS websites already exist for hospitals, nursing homes and other health care entities.

“They will be able to compare apples to apples because sometimes organizations will present data and it may not be the same across different organizations,” Parks-Shaw said. “This will allow them to get an accurate comparison from one organization to another.”