ProCare Opens Adult/Pediatric Hospice Inpatient Facility

ProCare Hospice of Nevada and CareOusel Pediatrics are opening a new inpatient care unit (IPU) that will provide palliative and hospice care to both adult and pediatric patients in the state’s southern region. The facility comes at a time when hospice providers and policymakers alike are recognizing and responding to a growing need for pediatric services for children and families facing serious and terminal illness.

The hospice inpatient unit will feature 14 beds and begin accepting adult patients in September, opening up to pediatric populations before the end of this year. The facility is among the first in the Silver State to be staffed by pediatric hospice and palliative care providers, according to ProCare Hospice.

“We truly understand the community’s need for a new hospice IPU, which is why this project has been a priority for us,” said Clevis Parker, M.D., CEO and chief medical officer of ProCare Hospice. “Our IPU will be an essential resource for patients who require aggressive, short-term pain and symptom management, and for those transitioning from the hospital to their home but require a transition step to stabilize their uncontrolled medical needs.”

ProCare provides community-based hospice and palliative care to patients and their families throughout the Las Vegas area and surrounding region. Services include home health aides, counseling, therapies, nursing services, physician services and short-term inpatient care. In addition to end-of-life and serious illness care, ProCare’s new inpatient unit in Las Vegas will also provide respite care for family or caregiver members who require time away.

Hospice utilization among Medicare decedents in Nevada reached 48.5% in 2018, according to the National Hospice & Palliative Care Organization (NHPCO). This was in line with the national average of 50% that year, reported by the Medicare Payment Advisory Commission.

Seniors represent the bulk of hospice patients in the United States, but providers are increasingly turning attention to a younger base as more families learn about the nature of hospice. Current data on pediatric hospice utilization are scarce, but indicators suggest that expansion of these services is underway throughout the hospice industry.

On average, a little more than 45,000 infants, children and adolescents die each year in the United States, in addition to 18,500 young adults between 20- and 24-years-old, according to research from the National Academy of Sciences.

In 2013, children 19-years-old or younger made up 1.6% (42,328) of overall deaths nationwide, with more than half (55%) of these childhood deaths occurring during infancy, according to a report from NHPCO. Roughly two-thirds of these died during the neonatal period.

Patients from prenatal through age 25 facing life-limiting illnesses or conditions are eligible to receive services through ProCare’s CareOusel Pediatrics program.

ProCare has one of the largest pediatric censuses in the West, Parker told Hospice News last year.

“We’re averaging almost 80 pediatric patients,” Parker said. “We helped develop the manual for the state of Nevada with the governor and his committee when the Affordable Care Act was enacted, and Nevada decided that they wanted to do the concurrent care for pediatrics. This group at ProCare worked directly with the Medicaid personnel from the governor’s office to develop and implement the pediatric palliative care/hospice program.”

Funding for pediatric services comes from Medicaid, private insurance and charitable donations made to the ProCare Foundation. The foundation also provides assistance to families lacking the financial means to pay for services.

The U.S. House of Representatives is currently considering a bill that would create programs within Medicaid to cover hospice and palliative care for terminally ill children.

The needs and conditions of pediatric patients differ from adults in terms of diagnoses, illness trajectories, medication dosing and equipment, as well as family dynamics and support.

Cancer and unintentional injuries were leading causes of death among youth populations aged 24 and younger, according to the U.S. Centers for Disease Control and Prevention’s 2021 Annual Summary of Vital Statistics report. Deformations and chromosomal abnormalities (congenital malformations) were among the most prevalent causes of death among children from 1- to 9-years-old in 2018 and 2019, accounting for 10.1% of deaths in this age group and 20.6% of deaths among infants, the CDC reported.

ProCare’s pediatric hospice staff includes a child life specialist that will provide developmentally and psychologically appropriate interventions for families to help reduce fear and anxiety, and to help them cope with end-of-life issues. The team is led by Kathleen Gates, MD, the only pediatric hospice trained physician in Nevada, according to the company.