LETTERS: HOSPICE STORY MISLEADING

To the editor:

I am writing about the Feb. 3 article regarding hospices and nursing homes.

I find that the information that was presented for publication is sketchy and misrepresentative. The law clearly states that the hospice must negotiate with nursing facilities to purchase nursing home room and board, as well as room and board for patients already in the nursing home who voluntarily elect to utilize their hospice benefit. Medicaid will only reimburse the hospice up to 95 percent of the current Medicaid rate for patients who are eligible for Medicaid in the nursing home. This agreement must be in writing, and these agreements must stipulate what the hospice is purchasing from the nursing facility. In addition to room and board, some hospices purchase additional services from nursing facilities above and beyond room and board. Missouri state inspectors from the Division of Aging and Department of Health began scrutinizing this over a year ago.

If the attorney general would contact the Medicaid branch of HCFA, like many providers such as myself have done, they will quote psalm and verse of what the law states.

As a side note, the National Hospice Organization is in the process of approaching the office of inspector general in Washington, D.C., to take a position on this issue. While the OIG is doing this, the Medicaid office in Jefferson City is assessing the situation and working on a solution. In the meantime, most hospices that I have regular contact with in Southeast Missouri and throughout Missouri are trying very hard to deliver excellent care to patients whether they live at home with families or in nursing facilities.

I have spoken with Jack Stapleton, who wrote the article, and explained that the information he provided was not complete. I offered to meet with him and explain to him how this hospice system works and that the nursing home portion is just a small segment of the hospice program funded by Medicare and Medicaid, all of which provides a savings similar to that of managed care.

I fear that this incomplete article will confuse your readers and affect the level of trust that area hospices have worked so hard to earn from patients, families and physicians. Working as long as I have in hospice, I know that those of us who really care about people facing a terminal illness must earn and maintain the trust of the communities we serve in order to be a true patient advocate. Families that have used hospice services in the Southeast Missouri communities do trust us. If you would like to publish a follow-up article, I would like to respond.

MATT BRAUSS, Executive Director

Provident Hospice Group Inc.

Sikeston