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In Hospice Care, Longer Lives Mean Money Lost (Patients Refuse To Die)
NY Times ^ | 27 November 2007 | By KEVIN SACK

Posted on 11/27/2007 6:50:27 AM PST by shrinkermd

Hundreds of hospice providers across the country are facing the catastrophic financial consequence of what would otherwise seem a positive development: their patients are living longer than expected.

Over the last eight years, the refusal of patients to die according to actuarial schedules has led the federal government to demand that hospices exceeding reimbursement limits repay hundreds of millions of dollars to Medicare.

The charges are assessed retrospectively, so in most cases the money has long since been spent on salaries, medicine and supplies. After absorbing huge assessments for several years, often by borrowing at high rates, a number of hospice providers are bracing for a new round that they fear may shut their doors.

One is Hometown Hospice, which has been providing care here since 2003 to some of the most destitute residents of Wilcox County, the poorest place in Alabama.

The locally owned, for-profit agency, which serves about 60 patients, mostly in their homes, had to repay the government $900,000, or 27 percent of its revenues, from its first two years of operation, said Tanya O. Walker-Butts, a co-owner. Its profits were wiped out in the time it took to open the demand letters, Ms. Walker-Butts said.

Hometown paid its first assessment with a bank loan. When the bank declined credit for the second year, the hospice structured a five-year payment plan with the Centers for Medicare and Medicaid Services, the federal agency that administers the program, at 12.5 percent interest.

(Excerpt) Read more at nytimes.com ...


TOPICS: Crime/Corruption; Culture/Society; Extended News; Unclassified
KEYWORDS: abortion; death; dutytodie; endoflife; eugenics; euthanasia; hillarycare; hospice; hospices; moralabsolutes; murder; nannystate; nationalhealthcare; prolife; righttolife; romney; romneycare; rtl; singlepayersystem; socialism; socializedmedicine; theywentthataway
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To: Earthdweller

Hospice care differs from state to state, even within a state. My husband was dying, he lived only 6 weeks. He spent only 3 nights in a hospital, and said that he wanted to die at home. With the help of hospice care, he was able to have that.

It is dreadful to have a bad experience with hospice, but in my opinion, we had one of the best.


41 posted on 11/27/2007 8:40:09 AM PST by Judith Anne (Thank you St. Jude for favors granted.)
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To: Hildy

No, no. My experiences aren’t really important. Please tell us all about yours. That’s what really matters.


42 posted on 11/27/2007 8:40:20 AM PST by trisham (Zen is not easy. It takes effort to attain nothingness. And then what do you have? Bupkis.)
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To: Hildy; trisham
Have you ever been with someone during their end of life?

I see the smugness is as pronounced as ever.

You seem to operate under the delusion that you are the only person who has dealt with someone dying. I have news for you, ALL of us either have or will (usually many times) have to deal with the death of loved ones; however, most of us aren't pushing the culture of death's agenda.

43 posted on 11/27/2007 8:42:14 AM PST by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: Earthdweller

Than I’m sorry you had such a negative experience. The majority of people haven’t. I thank God for hospice and I send money every year to the hospice that allowed my brother to die with dignity and comfort, in a home like setting with the people he loved around him, instead of a cold hospital, being tended to by strangers who didn’t give a rat’s ass about him.


44 posted on 11/27/2007 8:42:50 AM PST by Hildy (Faith is the bird that sings when the dawn is still dark.)
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To: wagglebee

My husband was in so much pain from the cancer that he wanted to kill himself. He said as much to me. When we got hospice, we found a whole different world of pain medication that made his last week so pleasant, we were able to talk a bit, tell jokes, he could eat a little, it was almost miraculous. The end was the same, but I’m convinced that without them, he would have had an agonizing death. As it was, both of us were grateful.


45 posted on 11/27/2007 8:44:51 AM PST by Judith Anne (Thank you St. Jude for favors granted.)
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To: wagglebee; Hildy
You seem to operate under the delusion that you are the only person who has dealt with someone dying. I have news for you, ALL of us either have or will (usually many times) have to deal with the death of loved ones; however, most of us aren't pushing the culture of death's agenda.

*****************

Ah, the culture of death. What's the attraction for some?

46 posted on 11/27/2007 8:44:53 AM PST by trisham (Zen is not easy. It takes effort to attain nothingness. And then what do you have? Bupkis.)
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To: Hildy
If you were told the operation cost YOU $250,000, what would you say then? That's the point. Someone else is paying.

Got it, it's about money.

And I suppose that if a parent or grandparent is a millionaire, then we should just kill them off so that there will be more money left over for us when they're dead.

But why stop at $250,000, why not a dollar, it all adds up.

47 posted on 11/27/2007 8:44:53 AM PST by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: shrinkermd
The charges are assessed retrospectively,

The NY Times doesn't know the difference between "retrospectively" and "retroactively?"

48 posted on 11/27/2007 8:44:56 AM PST by HIDEK6
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To: wagglebee; All

I want an answer...what did I say in ANY POST on this THREAD where I encouraged DEATH..I’m so sick and tired of being accused of this. Put your money where you mouth is...SHOW ME.


49 posted on 11/27/2007 8:45:22 AM PST by Hildy (Faith is the bird that sings when the dawn is still dark.)
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To: Judith Anne; Hildy
Hildy is not here to talk about responsible death and dying or reasonable hospice care, which is in the hospitals by the way.....she is here to promote the euthanasia agenda...period.

She uses the death of her mother as a cover to make those who want to dump their relatives feel less guilty. It's all about the money..and keeping the socialist agenda afloat...making it easy for future generations to not take responsibility .

50 posted on 11/27/2007 8:46:07 AM PST by Earthdweller (All reality is based on faith in something.)
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To: Hildy
I have had numerous “experiences” with hospice...numerous. There is a great market for it and you are one of it’s sales persons...aren’t you?
51 posted on 11/27/2007 8:48:03 AM PST by Earthdweller (All reality is based on faith in something.)
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To: Hildy

Thanks for sharing your experiences. There are many reasons for hospice care, and sometimes the patients who are at the ‘end’ of ‘medical’ knowledge and hospital-care do recover (if I can use that word) by having good care in their home.

It is possible that is what was happening to people cared for by this facility in Alabama.

My sister said ‘no more hospitals’ in March of her final year and lived until that October. She was surrounded with loving care by family under the supervision of a hospice facility.


52 posted on 11/27/2007 8:48:29 AM PST by maica
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To: Judith Anne

A year and a half ago my grandfather had some medical tests due to an enlarged prostate. During the exam, they discovered advanced pancreatic cancer. Surgery was almost certain to kill him and he wouldn’t even consider it. My grandparents contacted a hospice run by a group of nuns and they were wonderful. He lived the last four months at home surrounded by people who loved him and he was very much at peace with all of it.


53 posted on 11/27/2007 8:49:49 AM PST by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: maica
Right now there are some “good” hospices...they are the staging grounds for euthanasia facilities. You all are just frogs in a slowly warming pot.
54 posted on 11/27/2007 8:50:49 AM PST by Earthdweller (All reality is based on faith in something.)
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To: GOPPachyderm

I am all for Hospice - Hospice can be well done as in Branford they will let the patients smoke, drink brandy whatever makes them happy. Family can sit around and pump morphine on their own if they sense discomfort I can not say how much better it gets in branford if you have to go that’s the place to kick the bucket.

But there is Hospice that can be actually tortuous. I had my father and an uncle both meet their last days in nursing home hospice. Once the decision was made the course of action there was to completely immobilize them with Atavan(sp?) which is a muscle relaxant not a pain killer, so from observation it looks like they are just resting

I believe my father and uncle where at times fully conscious but could not move or even blink an eye and I had big fights with the doctors to get them enough morphine. I could tell they were in pain because there would be some agitation occuring just before the next atavan shot. The morphine was tough to get them to administer as they gave them the atavan they would stop moving and the doctor would say “see they are not complaining”

In nursing homes here in CT. you can walk in but in a couple of days you will not be walking or continent because they dose the patients up with Atavan to keep them in bed. With 2 nurses for 20 patients it allows them more control, keeps the patients from walking out, wandering about, just where they want them for medication, meals, doctors visits.

My Aunt was in a local nursing home and I went to visit her during a mealtime and the woman in the next bed was too drugged up to eat and when the nurse came to collect the meal I pointed out she hadn’t eaten the nurse just said she must not have been hungry and left the room.

Hospice is nice if done well, but it sucks getting old - Massive heart attack is the way to go


55 posted on 11/27/2007 8:51:17 AM PST by underbyte
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To: Hildy; trisham
I want an answer...what did I say in ANY POST on this THREAD where I encouraged DEATH..I’m so sick and tired of being accused of this.

You're kidding right?

Why don't you find us all a thread where YOU have ever taken a pro-life position.

56 posted on 11/27/2007 8:52:32 AM PST by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: Earthdweller

Sorry, I meant to ping you to this.


57 posted on 11/27/2007 8:53:33 AM PST by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: shrinkermd

I think Dr. Kevorkian has just found a new market. “You make lots of money by following my tried and true trade secrets!”


58 posted on 11/27/2007 8:54:32 AM PST by hoppity
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To: wagglebee
Don’t ping me..I already get all the pings. This subject really p8sses me off..so I’ll let you fight it for me. :) You are doing fine by the way.
59 posted on 11/27/2007 8:55:34 AM PST by Earthdweller (All reality is based on faith in something.)
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To: Earthdweller

And you have a very limited knowledge of the reality of hospice care, or else your own personal interaction with a hospice situation has led you to see the care someone you knew as euthanasia. You might want to broaden your horizons just a bit.

Hospice care is all about comfort, and making the progress of a terminal illness as most like normal life as possible. It is about life, not death!


60 posted on 11/27/2007 8:58:44 AM PST by maica
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