Pending regulatory approval, Alaska-based Bartlett Regional Hospital may be stepping in to fill care delivery gaps after a local hospice closed due to labor shortages.
Hospice and Home Care of Juneau (HHCJ) shuttered its services last year, 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. The organization is operated by Catholic Community Service. Though the nonprofit hospice and home health provider continued volunteer and spiritual care services, it halted all others.
Bartlett Regional Hospital has applied for home health and hospice licensure to offer those services in HHCJ’s former markets. The hospital expects to hear back from the state on approval either this month or in February, according to local news reports.
The hospice’s closure left patients and families across the community and surrounding areas with limited access to end-of-life care, according to Nathan Rumsey, business development strategist at Bartlett Regional Hospital.
“In the meantime, that obviously puts those people at a disadvantage — especially if they can’t seek some type of service outside of this community,” Rumsey told local news. “That’s why we’re trying to move as quickly as we can to reestablish those services.”
Alaska is a certificate of need (CON) state, though lawmakers in 2022 introduced bills that could impact those requirements.
With the state’s approval, the hospital will set efforts in motion to expand its hospice and home health workforce to alleviate current lapses in service, Rumsey said.
The slim patient volumes at the time of HHCJ’s closure reflect a wider issue of workforce pressures, limited capacity and rising labor costs, according to Catholic Community Service Director Erin Walker-Tolles.
Prior to the pandemic, HHCJ had an average of 60 residents on its service, Walker-Tolles she told local news. A heavy reliance on costly travel nurses during the COVID-19 outbreak took a financial toll on the nonprofit’s ability to remain afloat.
“There is a massive health care worker crisis happening in this country … the [shortage] is affecting especially nonprofit and smaller health care providers. And it’s especially challenging in Alaska,” Walker-Tolles said.
Hospice utilization is low statewide compared to other states, in part due to lower senior population rates and large rural regions that lack providers. In 2021, 1,122 Medicare beneficiaries in Alaska utilized the hospice benefit, according to the U.S. Centers for Medicare & Medicaid Services (CMS). California saw the most hospice utilization that year, with 156,000 beneficiaries electing these services that same year.
This is largely due to the population sizes in each of those two states, nearly 733,000 in Alaska compared to 39.2 million in California, according to the U.S. Census Bureau.
Bartlett Regional Hospital is currently laying the groundwork to reestablish hospice and home health services across the service area, according to Rumsey.
“There are many patients that would otherwise be able to seek care and get care in their homes that are finding their way into the hospital for other reasons, because they can’t get that,” Rumsey said. “And that’s a frustration to everyone.”