Two hospices have lost the battle against workforce shortages, with one halting some of its service lines and another shutting down altogether.
Hospice and Home Care of Juneau shutters
Alaska-based Hospice and Home Care of Juneau (HHCJ) recently announced its closure, citing high staffing costs and lack of clinicians. HHCJ had two hospice and 17 home health patients on its services when the closure took effect on October 19.
“We are unable to continue providing services due to lack of registered nursing staff,” the company stated in an announcement. “Like many other hospice and home health programs across the nation, as the national health care worker shortage continues and the cost of health care staff and other expenses skyrocket, we are finding it increasingly difficult to manage the rising costs of doing business.”
The nonprofit hospice and home health provider became Medicare certified in 2006, and is operated by Catholic Community Service.
HHCJ’s additional services included bereavement care, as well as free medical equipment loans for wheelchairs, walkers, crutches, bath benches, bedside commodes or canes. The organization’s volunteers also provided companionship, caregiver respite, therapeutic massages, meal delivery, construction tasks, errands and recording of life histories, among others services.
A second factor in the closing is that hospice and home health reimbursement is lagging in covering the rising costs of delivering care.
“Medicare, Medicaid, and private insurance payments for patient services are not keeping up with these unprecedented increases in expenses,” Catholic Community Service indicated in the press release.
HHCJ’s volunteer and spiritual care services will continue for hospice patients.
Until solidified plans move forward, the discharged patients and families have all been referred to primary care providers to develop individual end-of-life and home health care plans.
“Unfortunately, there is not another agency in Juneau to assume the care of these patients, so patients will follow up with their physicians to develop individual plans to address their medical needs,” said the company in the announcement. “Patients and caregivers have been educated on when to call 911 for immediate life-threatening illness. Supplies required for the caregivers and patients have been left in the home.”
The company stated in its announcement that it is “hopeful that both hospice and home health services will become available in Juneau soon.”
Catholic Community Services is currently coordinating with officials at the Bartlett Regional Hospital and the Southeast Alaska Regional Health Consortium (SEARHC) to ensure that the community has continued access to hospice and home health services. The agency is currently exploring the potential for the hospital and health system to provide some or all of the affected services in the future.
“It’s difficult to be in a situation where we can’t provide the care we’ve provided during the past 20 years,”
Erin Walker-Tolles, executive director of Catholic Community Services, told local news. “But it will be faster for the community if we suspend and Bartlett [Regional Hospital] picks up the program, since the hospital already provides some related services and it would likely take a new organization a year or more to get regulatory approval.”
The hospital is currently “working to obtain licensing with the State of Alaska, as well as negotiating through our legal department to establish a format where we can reestablish these programs for the citizens of our service area,” according to Erin Hardin, director of community relations at Bartlett Regional Hospital.
Alaska is among the 35 states with a certificate of need program currently in place, reported the National Conference of State Legislatures (NCSL). However, lawmakers have introduced bills that could change the state’s CON requirements.
Demographics are swelling demand for serious illness and end-of-life care in Alaska. Seniors 65 and older represent 13.6% of the population in Juneau, Alaska, according to the U.S. Census Bureau. This age group is projected to outpace others by 30% by 2050, reported the Alaska Department of Labor & Workforce Development.
Hospice utilization among Medicare decedents in Alaska was the lowest in the nation in 2018 at 22.8% in 2018, according to the National Hospice and Palliative Care Organization (NHPCO).
Vermont hospice shuts down three service lines
Staffing issues have led The University of Vermont (UVM) Health Network – Home Health & Hospice has halted its caregiving services to residents with mobile impairments at South Burlington Community Housing. Personal care and social work referrals will also end.
The senior housing community offers 10 one-bedroom apartments, and is owned and operated by Cathedral Square, a nonprofit organization. Its residents are typically low-income. These services will halt effective November 4.
“This is a heartbreaking situation,” Cathedral Square CEO Kim Fitzgerald told local news. “But it’s a completely understandable one, given the staffing crisis that we are having in the state of Vermont.”
The home health and hospice will also cease to accept patient referrals from the senior housing community for those who require personal care attendant services as well as case management/social work service referrals, according to local news.
The parent organization, the UVM Health Network, serves a patient population of more than 1 million in Vermont and northern New York. Its home health and hospice segment employs 458 staff who have provided care to 4,556 patients. The organization’s hospice patient census volume grew 20% from 2020 to 2021.
Seniors are projected to make up 29% of Vermont’s overall population by 2030, a rise from 20.6% currently, according to the U.S. Census Bureau.
Hospice utilization among Medicare decedents in Vermont reached 42.9% during 2018, according to NHPCO. Though this was a 22.26% increase from the state’s rate in 2014, it still fell below the national average of 50.3% that year, NHPCO reported.
The hospice and home health provider is currently working with the Vermont Department of Disabilities, Aging & Independent Living to ensure that every resident at the senior housing facility receives care in “the most appropriate setting,” according to Nissa James, director of communications and engagement strategies at UVM Health Network – Home Health & Hospice.
Additionally, the provider is also focused on retaining and reallocate its current staff of caregivers at the facility “to ensure that every single personal care attendant and licensed nursing assistant who works for us currently is able to transition to a different job within our organization,” James told local news.
Companies featured in this article:
Bartlett Regional Hospital, Cathedral Square, Catholic Community Services, Hospice and Home Care of Juneau, National Conference of State Legislatures, National Hospice and Palliative Care Organization, South Burlington Community Housing, Southeast Alaska Regional Health Consortium (SEARHC), The University of Vermont Health Network – Home Health & Hospic