Reliable vendors have a role to play in hospices’ financial and operational sustainability as well as regulatory compliance. Particularly during the pandemic, reliance on technology and staffing services have come to the forefront, as has maintaining the durable medical equipment (DME) and pharmaceutical supply chains.
Finding efficient and responsive service providers is extremely important for hospices in a crowded market, according to Nicole Knight, administrator of Texas-based Vantage Hospice. Hospices need to ensure that they are doing diligence in building relationships with vendors to deliver on service and product promises, as these ties can impact not only bottom lines, but the patient care experience and referral streams, according to Knight.
“Your partners that are helping provide that care are vital to the success of your organization,” Knight told Hospice News. “Especially in an environment where there’s a lot of competition, that DME vendor or that pharmacy vendor can ruin you if they don’t do what they say they’re going to do when they say they’re going to do it. You don’t get a second chance with a lot of the referral sources. If you screw up they’re just going to move on.”
Staffing is a large gap that vendors help hospices to fill, especially as human resources stretch increasingly thin, according to Knight. In addition to maintaining operations and patient care, staffing can impact patient perception, experiences and overall quality of care received at the end of life, Knight indicated.
While the rising need for contracted staffing services has strained providers’ pocketbooks — leading to some accusations of price gouging — they have helped hospices maintain patient volume while full-time employees entered quarantine or sick leave.
However, patients and families rarely distinguish between a contracted nurse or a full-time hospice employee. When they enter a patient’s home, the contractor is the face of the organization, so providers are taking steps to ensure those clinicians are aligned with their mission.
“I tell our staffing partners all the time that perception is reality to that patient,” said Knight. “The great thing about our vendors is they all buy into that philosophy so that we’re all thinking in the same way, we all have the same goal in mind, and we all work to the same high standard. It’s important that you find partners that share that vision with you, because if you don’t then they definitely are working against you and not with you, and it hurts you a lot.”
Staffing issues have topped the list of hospice provider concerns for several years and have only grown more severe during the pandemic.
Some hospice providers and health systems have shut down their programs or sold off their operations out of an inability to recruit or retain a sufficient number of employees.
Workforce issues continue to pose a significant hurdle for hospice and palliative care providers as this year unfolds, according to insight gathered from the 2022 Hospice News Outlook Survey and Report.
Survey questions focused on the largest issues facing the hospice industry this year, along with growth opportunities on the horizon. More than 67% of respondents reported that staffing was their greatest challenge in 2022, with staff engagement and satisfaction being the No. 1 factor driving technology investments for the year ahead. This is up from 45% of respondents to last year’s survey.
Hospices have been in a tough position from a labor market perspective, and this is where vendors can step in to help create efficiencies, according to Daniel Reese, CEO of IntellaTriage. The company provides after-hours nurse triage staffing support for hospice and home health providers.
“There’s a lot of pressure right now to improve work-life balance for nurses and try to reduce the burnout while hospices are also seeing census pressure for growth,” said Reese. “Labor efficiency is really important right now in the market. The first step for our provider partners is just being honest with evaluating the problem and talking with your team so you have a baseline of how much of a dissatisfaction there might be and the scope of how much it’s contributing to burnout and turnover.”
Vendors can also help or hinder a hospice’s regulatory compliance.
Hospices facing increasing regulatory scrutiny on a host of issues, including rules and guidelines for DME and pharmacy. This includes processes and procedures for cleaning, disinfection and sterilization, as well as monitoring, distribution, transportation and patient and staff education, Knight told Hospice News.
Providers must be able to communicate with vendors about their own compliance strategies and how they could affect their organization and patients, according to Knight.
“There is absolutely no way that we as hospice organizations can keep up with DME and pharma regulations, in addition to our own. It’s an overwhelming task,” said Knight. “If we had to absorb these on our own, costs would be astronomical. Having that cost effective piece with service providers is vitally important, but what you really need to look at is if you’re getting what you’re paying for with their services or products. Are they worth it? Cost really should not be the first thing that you’re looking at. Their ability to meet or exceed your expectations should be the number one driving factor.”
Hospices consider factors other than cost when selecting a vendor. While every dollar matters in today’s climate, a low bidder can cost a hospice more in the end, according to Pat Leary, vice president of client services for Enclara Pharmacia.
“The biggest red flag is vendors who compete solely on price, because their goal is going to be to make it up on volume by selling you more than you need,” said Leary. “When evaluating vendors, hospices need to ask the right questions. It comes down to that overall value proposition — not just what the vendor is selling but the manner in which they provide it.”
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