Hospice Unit Closes in Pennsylvania, Sparks Community Outrage

Pennsylvania-based Crozer Health has temporarily halted inpatient hospice services at its unit in Taylor Hospital, citing declining admissions and staffing shortages as leading factors. The move sparked community outcries amid rising demand for end-of-life care. 

Crozer Health is part of Kroeger Health Systems and is owned by Los Angeles-based Prospect Medical Holdings, Inc., which acquired the company in 2016 for a price tag of $300 million. In addition to Taylor Hospital, three other hospitals make up Crozer Health, including Crozer-Chester Medical Center, Delaware County Memorial Hospital and Springfield Hospital.

Crozer Health’s Hospice Residence at Taylor Hospital is a 10-bed inpatient unit featuring private patient rooms and bathrooms designed to create a home-like setting. The unit has public dining and activity areas for patients and families, along with kitchen and shower facilities. Current patients in the unit are being transferred to the medical surgical floor at Taylor Hospital.

“Declining admission to inpatient hospice, due to a paramount need for patient safety, and challenges presented by national nursing shortage, Crozer Health will temporarily close our inpatient hospice unit at Taylor Hospital,” stated officials in a statement issued by Kroeger Health. “This will allow us to redeploy our staff from the hospice unit to other areas of the health system in need of additional resources so that we can continue to provide safe, high-quality care to all of our patients.”

Patients’ families reported that they were “stunned” to be informed of the closure and moving their loved one out of the unit at a fragile stage of life. Families and staff alike raised concerns, according to local news reports.

“Why do you work all these years to save and have something for when you are in this stage of life and then it doesn’t matter. It just doesn’t matter. They don’t care,” one family member told local news. “We’re all very upset. Even the workers are like, ‘I can’t believe this is happening. This just doesn’t seem right.’”

This is the latest of a rash of hospice closures, inpatient unit shutdowns or sales due to the staffing shortage during the past 18 months.

The closure also comes at a time when a growing aging population is driving up demand for hospice nationwide. Similar to national trends, the proportion of seniors is outpacing other age demographics as it swells in the Keystone State.

Nearly 17% of the population in the Delaware County area alone are seniors, according to Census Reporter data. In 2017, the number of seniors 65 and older grew to 2.27 million, or 17.8% of Pennsylvania’s overall population, a rise up from 1.96 million (15.4%) in 2010, according to data from the U.S. Census Bureau. This represented a growth rate of 20x that over other age demographics/the state’s general population that year, according to the Pennsylvania State Data Center. The bureau projected that seniors will make up more than a quarter (27.5%) of the state’s population by 2030.

Hospice utilization among Medicare decedents in Pennsylvania reached 48.4% during 2018, according to the National Hospice and Palliative Care Organization. This falls slightly under the national average of 50.3% that year.

Closure of the hospice unit was followed by news that the health system will soon be sold. Prospect Medical Holdings initially indicated it was conducting a strategic review of Kroeger Health Systems that may result in new opportunities or partnerships. The company has since moved forward on the review.

Christiana Care Health System, Inc. recently announced that it will acquire Crozer Health from current owner Prospect Medical Holdings in a letter of intent. The purchase includes Taylor Hospital, among other Crozer Health assets such as ambulatory centers, medical office buildings, physician clinics and ancillary outpatient services. Crozer Health currently operates as a for-profit organization with roughly 4,000 employees providing care, but will revert to a nonprofit status/entity under Christiana Care upon the transactions closing, anticipated to come at the close of 2022.

Combining the organizations was a move made to expand access to care and join staffing forces, according to Kevin Spiegel, CEO of Crozer Health.

“The pandemic has demonstrated the vital importance of working together to meet the clinical needs of the communities we serve,” said Spiegel in the announcement. “We are excited by the potential to join these two great organizations so that we can continue to provide the high-quality, accessible care that our communities — Delaware County and beyond — rely on.”