Unity Hospice and Palliative Care Expands General Inpatient Care

Unity Hospice and Palliative Care of Greater Houston has unveiled a five-year general inpatient (GIP) service agreement with the University of Texas Medical Branch (UTMB) Health.

The hospice will provide GIP care across the health system’s four hospitals. UTMB Health’s service region includes 10 cities in Texas.

Among the driving forces behind the service agreement is a rising demand for end-of-life care among patients with complicated and intensive symptoms, according to Natalie Leriger, executive director and administrator at Unity Hospice and Palliative Care of Greater Houston.


“The reason why we have strived to provide more GIP care within the hospital setting itself is [because] it is important as patients are becoming more complex that we are able to meet those needs for symptom management,” Leriger told Hospice News. “It’s going to be imperative as we move into the future. Like many regions, we have more older populations coming into the hospital who are sicker and need higher pain and symptom management. That tends to lend toward the GIP level of care.”

GIP is a more medically intense level of hospice intended for patients with symptoms that cannot be managed in the home. The intensity of GIP care often includes higher-cost services such as increased medication management, 24/7 clinical staffing assistance and other operational expenses.

This level of care can be difficult to navigate in hospital settings amid widespread staffing shortages and clinical capacity pressures proliferating in health care, according to Leriger.


Unity Hospice and Palliative Care serves 13 counties in Texas. The hospice and palliative care provider partners with St. Luke’s Health and Houston Methodist Leading Medicine, among other health systems. Established in 1992, Unity Hospice and Palliative Care also provides care in northern Illinois, northwest Indiana and across communities in St. Louis, Missouri.

Opening in 1891, UTMB Health operates emergency and urgent care centers in the Houston area, as well as 13 primary and specialty care clinics. The health system offers behavioral health, pediatric care, orthopedics and women’s health care, among other services.

UTMB Health is a part of The University of Texas System and a member of the Texas Medical Center. The health system’s educational areas include medicine, nursing, public and population health, biomedical sciences and other health professions.

The health system’s clinical educational model was an additional consideration fueling the partnership, Leriger said.

“We sought them out partly because they have an academic medical center that strives to provide advanced treatment options and has been open a long time,” Leriger said. “We felt this would be a blessing to be able to work with them and be impactful in the community. They have been around for more than 130 years, so it just made sense to reach out. We’re really focusing on providing quality of care for patients and families needing GIP level of hospice care. It’s a collaboration we hope to continue.”

More than 20% of the population in Texas will be 65 and older by 2030, a rise from 13.4% currently, reported the U.S. Census Bureau.

About 143,284 Medicare decedents utilized the hospice benefit in Texas during 2021, according to the U.S. Centers for Medicare & Medicaid Services (CMS). This made the state third nationwide in hospice utilization rate, falling behind California and Florida at 156,000 and 154,521 decedents, respectively. 

Unity Hospice and Palliative Care is in the works of developing a similar GIP collaboration with Houston Hospice, according to Leriger. Established in 1980, the nonprofit hospice is also part of the Texas Medical Center. The organization serves 13 counties in southeast Texas and offers hospice, grief support services and a veterans program.

Houston Hospice in October 2023 began opening up its inpatient unit for use to other providers across its service region. The move was aimed at fostering better quality of care, CEO Rana McClelland previously told Hospice News.

“We have been in contact with Houston Hospice to be a part of that facility and be able to utilize it for GIP,” Leriger told Hospice News. “It’s an important level of care that with the stronger you are in presence, the more you can provide it. The key to moving forward with these collaborations is open communication and consistently identifying where you can improve quality.”

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