After sunsetting in September 2019, Oregon-based Hopewell Hospice is set to reopen late this summer after a nonprofit group raised close to $4 million. With the reopening, the hospice plans to update its approach to the delivery of end-of-life care.

The nonprofit, Friends of Hopewell House, began in 2020 with a goal to resurrect the general inpatient hospice house through a $5 million campaign. More than 1,200 individuals and organizations have donated the $4 million funds thus far in support of the hospice house’s reopening.

The remaining $1 million is needed to complete improvements required for licensing, pre-opening staff costs and provide a reserve of financial assistance, according to Susan Hearn, the nonprofit’s other co-executive director.

“The Hopewell House residential hospice model recognizes previous strategies for often put too great a burden on family members, especially when hospice provider visits only a few hours each week,” Hearn told Hospice News. “The 24-hour-a-day care needed in most circumstances at the end of life often falls on the shoulders of elderly or overwhelmed loved ones.”

Friends of Hopewell Hospice purchased the facility for $2.55 million from previous owner and operator Legacy Health Systems. This was a $1 million discount from the original pricetag.

Financial strain was a leading factor in Legacy’s decision to close the hospice house’s doors and sell, according to Maureen Andrews Bradley, Legacy’s senior vice president for philanthropy and community engagement. Bradley indicated to local news that pharmaceutical costs and clinical staff salaries were financial strains.

Hearn echoed these factors, adding others such as high expenses of durable medical equipment and “restrictive Medicare general inpatient admission criteria.” Hearn indicated criteria led to decline in the facility’s overall census, such as the requirement to discharge of hospice patients as soon as symptoms were under control.

“The general inpatient criteria limited the care to only 1.6 % of the population of hospice patients,” said Hearn. “The new hospice specialty residential care facility model serves the much larger percentage of hospice patients who cannot manage the 24-hour care at home.”

Prior to closing, more than 10,000 patients received care at the facility since it opened in 1987. Located in the southwest region of Portland, Ore., the reopened hospice house is a Tudor-style residential home built in 1926 for the Henningsen Family of Henningsen Cold Storage Co.

Once reopened, the hospice house will feature 13 beds and be supported by 25 employees and roughly 150 volunteers. In addition to 24/7 hands-on patient care, the revamped facility will serve as the center for community education about hospice, palliative care and societal perceptions of death.

Oregon ranked ninth nationwide in hospice utilization among Medicare decedents during 2018, according to the National Hospice and Palliative Care Organization. This tipped above the national average of 50.3% that year.

A swelling aging population is anticipated to drive up demand for terminal and serious illness care in the Beaver State. Seniors 65 and older account for 13.2% of Portland’s population alone and 18.2% of the overall state’s, according to the U.S. Census Bureau. The proportion of adults 75 and older will nearly double statewide by 2040, according to projections from the Oregon Office of Economic Analysis.

Though many indicate a preference to die in the home or at home-like settings, only 36% of Oregonians actually do, Hearn told a local news source, citing issues such as caregiver breakdowns and a lack of sufficient support systems in place.

Hopewell House is reopening to address the primary reason people need residential hospice care due to a crisis or breakdown of caregiver support at home, Hearn told Hospice News.

“The newly reopened Hopewell House will use a less costly, more sustainable collaborative residential care facility model,” said Hearn. “By collaborating with visiting Medicare certified hospice agencies who oversee the plan of care and pay for the necessary medications and equipment, the costs are reduced by more than half.”

Providing additional support for those with limited options for hospice care was among the main reasons that drew Lesley Sacks to serve as Hopewell House’s new administrator, according to a recent company announcement. Sacks previously served in social services for Traditions Health, formerly Hospice Care of the Northwest.

Part of the provider’s plan is to offer comprehensive and innovative care in a home-like environment for patients who can’t receive care in their residence and do not wish to be hospitalized, according to Scott MacEachern, co-executive director at Friends of Hopewell House. MacEacher, a previous volunteer at the hospice, led the charge in raising $2 million of the capital campaign.

“We were very thoughtful in regards to bringing innovation into our mission statement because there’s just a gamut from legislation to new therapies, new ways of thinking, there’s so much going on in the death and dying space on which the government is just lagging,” MacEachern previously told Hospice News.

The organization will be experimenting with new home-grown payment models such as bed day grants. These are based on relationships with local hospitals and hospices that can purchase a number of bed days in Hopewell House for their patients who need residential care. This practice can save a hospital tens of thousands of dollars monthly, according to MacEachern.

The facility will only accept hospice patients. These patients will receive interdisciplinary care from nurses, nurses’ aides, certified nursing assistants and clinicians, with 1-to-4 staff to patient ratio during the day and 1-to-6 at night. Patients admitted to the facility will be under the care of a primary hospice team in collaboration with the nursing staff hired by Hopewell House.

“Unlike many other care settings, the focus of care matches the priorities of dying people: to have pain and symptoms managed, loved ones nearby, human touch, a sense of control and mental awareness,” said Hearn.