Patients must qualify for in-patient care

A recent article in the New York Times stated that federal investigators found that some hospices bill Medicare for a higher level of care than patients need. While this may be true of some hospices, it is not true for all and certainly not true for Niagara Hospice. The article also stated that investigators found that for-profit hospices were more likely than other hospices to bill inappropriately for general inpatient care.

Niagara Hospice Vice President of Hospice Services, Joann Stoll, RN, CHPN said, "Each patient considered for in-patient care is evaluated to ensure they meet Medicare criteria for our certified GIP beds." Niagara Hospice is a not-for-profit agency in Niagara County that includes Niagara Hospice House that holds 10 residential and 10 in-patient suites. "It's disheartening to know that improper billing practices used by some for-profit hospice agencies casts a dark shadow on so many other hospice programs that truly exist for the purpose of providing the best quality care to patients," said Stoll.

There are clearly significant differences in hospices that are run by non-profit, local boards and those that are run by for-profit chains in other areas of the country. It's disturbing to learn that there are hospices who choose not to follow all of the same standards that Niagara Hospice follows, including Medicare guidelines and criteria, and Accreditation Commission for Health Care (ACHC) Standards. The ACHC has awarded Niagara Hospice with its accreditation for hospice care for demonstrating a commitment to providing quality care and services to consumers through compliance with ACHC's nationally recognized standards for accreditation.

In response to the report, Andrew Slavitt, top Medicare official, said he was stepping up supervision of hospices because he was concerned about "care being billed for but not provided, long lengths of stay and beneficiaries receiving unnecessary care."

National Hospice and Palliative Care Organization (NHPCO) members have been advised to pay strict attention to the requirements for inpatient care. As a Medicare funded and not-for-profit program, Niagara Hospice firmly follows Medicare guidelines while also ensuring the best quality of care for patients, and supports for family caregivers.

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