Non-profit vs. for profit hospice

[visceral0775]

I was once told to avoid working for for-profit hospice agencies if possible. Anyone have any thoughts on this?

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[Frazier]

There are good and bad organizations for both sides. Nonprofits have some extra hoops to jump through in regards to forming their organization and financial filings.

A criminal entrepreneur can start a hospice with the label of non-profit, and practice the same shoddy business practices/encourage crappy medicine as if they formed as a for-profit.

Choose carefully.

Usually inpatient palliative teams have a good handle of which hospices in their region are "good" or "bad". Ask around if possible. Otherwise some important questions include how long has the hospice been in business, what is the role of the executive director/CMO in your clinical decision making, where are they getting their referrals from, what is their approach to LCD's/hospice eligibility criteria for enrollment, and what is the nursing/social work/chaplain/aide/volunteer workforce.

If it is a for-profit that has been around for decades, gets majority of referrals from nearby hospitals/palliative teams/cancer center, the physician is able to make their own decisions and not just a rubber stamp for rigid clinical protocols/flowcharts, has clear enrollment eligibility criteria, and there is a healthy supply of staff that has stayed with the organization for years.... I am going to choose that "for-profit" over the brand new non-profit started by the recent MBA graduate with aggressively rigid medication dosing protocols, a bare-bones LEAN crew of supporting staff, and "enrolls everyone" (what's an LCD?) with the majority of referrals from a few random clinicians/direct marketing/etc.

If all else fails, interview. If the people and practices suck, jump ship. It is not worth hurting patients/families, hospice reputation, or your own future from malpractice or by going to jail for fraud.

 

[visceral0775]

There are good and bad organizations for both sides. Nonprofits have some extra hoops to jump through in regards to forming their organization and financial filings.

A criminal entrepreneur can start a hospice with the label of non-profit, and practice the same shoddy business practices/encourage crappy medicine as if they formed as a for-profit.

Choose carefully.

Usually inpatient palliative teams have a good handle of which hospices in their region are "good" or "bad". Ask around if possible. Otherwise some important questions include how long has the hospice been in business, what is the role of the executive director/CMO in your clinical decision making, where are they getting their referrals from, what is their approach to LCD's/hospice eligibility criteria for enrollment, and what is the nursing/social work/chaplain/aide/volunteer workforce.

If it is a for-profit that has been around for decades, gets majority of referrals from nearby hospitals/palliative teams/cancer center, the physician is able to make their own decisions and not just a rubber stamp for rigid clinical protocols/flowcharts, has clear enrollment eligibility criteria, and there is a healthy supply of staff that has stayed with the organization for years.... I am going to choose that "for-profit" over the brand new non-profit started by the recent MBA graduate with aggressively rigid medication dosing protocols, a bare-bones LEAN crew of supporting staff, and "enrolls everyone" (what's an LCD?) with the majority of referrals from a few random clinicians/direct marketing/etc.

If all else fails, interview. If the people and practices suck, jump ship. It is not worth hurting patients/families, hospice reputation, or your own future from malpractice or by going to jail for fraud.

Thank you! A job opportunity opened up with a local for-profit that our IP Palliative team refers a lot to (and seems to really like). But...someone once told me to stick with non-profit if possible. I will definitely do my homework and find out as much as I can about this organization of course 😉 The questions you posed are great as well! Thank you.