Letters

As president and CEO of East End Hospice, my inbox was flooded last week after an article appeared in The New Yorker magazine titled “Endgame: How the visionary hospice movement became a for-profit hustle.”

Reading the piece, I found a story that effectively details hospice in a few states where the lack of regulation has allowed for-profit entities to take over the industry.

In these states, venture capitalists and other nonmedical professionals open hospices for the sole purpose of profit. They collect Medicare’s standard daily payment for each patient while providing the least allowable care. Their practices are substandard at best, and abusive and fraudulent at worst.

While the article’s stories of individuals exploited by profit-driven hospices are compelling, the author fails to tell the full story. Let me provide a more comprehensive picture.

Every week at East End Hospice, the entire clinical team meets to discuss the more than 100 patients under our care at any given time. Nurses, social workers, chaplains and aides all provide input on how best to meet the medical, spiritual and emotional needs of each patient and their loved ones. When the team disperses across our 430-square-mile territory, each person has an individualized plan that ensures every patient is safe, comfortable and supported.

This is what it means to be a mission-driven rather than a profit-driven hospice. Far from restricting nursing visits to keep costs down, we encourage our nurses to stay with patients as long as necessary to make them comfortable.

Beyond physical comfort, social workers and chaplains provide emotional and spiritual support to lessen anxiety and empower people to seek joy in life for whatever time they have left. Our expert, compassionate care is the reason for our 98.5 percent caregiver satisfaction rating.

So, how do we account for such extremes in the industry? Much has to do with state regulations. The Centers for Medicare and Medicaid Services provides national oversight, but individual states vary greatly in controlling who can operate a hospice.

New York State strictly regulates the industry, which limits the number of for-profit hospices and actively roots out cases of fraud and abuse. Most hospices in New York seek to provide the comprehensive care that hallmarked the original hospice movement.

The author makes sweeping generalizations about the hospice industry that only reinforce our vision to remain independent and mission-driven. The exceptional services we provide almost always outpace the payments we receive from Medicare, but community support makes our care possible.

Donations big and small ensure that the East End has access to expert, compassionate care for people facing serious illness and their loved ones. We are honored to do this work and grateful for our supporters.

Mary Crosby, RN MPH

President and CEO

East End Hospice