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New York Times article features Hometown Hospice in look at issues The plight of a Jackson-based hospice has gotten the attention of national media such as The New York Times, CBS Radio News and Oprah Winfrey. In a Nov. 27 Times article, the issue of Medicare payments to Hometown Hospice and the impact on its clients, particularly in Wilcox County, was explored. Hometown Hospice, from its office in Camden, serves clients such as Loretta L. Pettway, 65, who lives in Gees Bend and suffers from chronic heart disease. "She's living out there with no running water, with no family…no relatives, no caregivers," said Gaines McCorquodale, a Jackson attorney and one of the owners of the facility. A shortfall in Medicare funding could mean that the hospice staff can no longer see her, and she will die "in squalor, by herself, and it may be two weeks before anybody knows. "…This is not a problem that is unique to Hometown Hospice (which began operation in 2003). It affects all hospice providers. "…When hospice was created in 1982, everybody that came under hospice suffered with cancer," he said. At the time they had two distinct budgetary caps. One was the number of days that a client was allowed to stay on hospice care (roughly six months), and the other cap was on the amount a provider (the hospice) could get paid for taking care of the client. "Those caps back then corresponded with each other," he said. In 1998, the U.S. Congress and Medicare allowed hospices to also care for people with diseases such as Alzheimer's, dementia or congestive heart failure. The death time for terminal cancer patients was more predictable than clients with other diseases, McCorquodale said. Therefore, Congress did away with the cap on the number of days. So long as clients qualified and were re-certified, they could still be served by the hospice. "So theoretically, somebody can remain on hospice for two to three years. That's far different than that original six months. What they didn't do was amend the cap for the amount of Medicare funding the provider receives. They kept paying for only six months." The hospice currently serves from 55 to 65 clients in its two offices in Jackson and Camden. The Medicare funding shortfall either forces Hometown Hospice to remove needy clients or continue to take care of them and "we are simply not - whether Medicare pays us or not - willing to walk away," McCorquodale said. "…We're not willing to look in that mirror at night and know Ms. Pettway's over there and not being taken care of. "…Now it doesn't take an MBA to understand that's a recipe for going broke." Medicare reimburses the Jackson hospice $117.44 for each day of care. When the area hospice exceeded what Medicare would pay, Medicare has demanded refunds - approximately $900,000 up to 2005. McCorquodale is waiting any day for a bill for 2006. The goal of the National Alliance For Hospice Access is for Congress to put a three-year moratorium on the cap collections, that being collections for 2005 through 2007. "We're not asking them to abolish it," he said. "...We're not asking them to give us more money….(Simply) stop those collections. Time out! And then let Congress, Medicare, Med Pack, every stakeholder who has an interest in this, spend some time and study the problem." "It's going to take them at least that long to be able to make their decision," said Tanya Butts, a coowner of Hometown Hospice. With the aging of the Baby Boom generation, hospice or home health services will be essential. Duke University had done a study where such services are "great for both sides," she said. "It's economical, and it's great for the patient - because they want to remain at home." It's unfortunate that the Medicare issues make it hard for hospice staff to celebrate that a client is living longer. The clients are receiving needed medicine, bathing, food and the attention they need. "We become part of their family," Butts said. The clients look forward to those visits, "and, of course, they live longer." "These ladies (nurses) that do this work are to these families like angels coming," McCorquodale said. He expects Congress to fix the problem, but they better do it soon before independent hospices go out of business. As much as the owners of Hometown Hospice are thrilled by the national media coverage they have received lately, they wanted to make it clear they are not going out of business.
"We're OK," Butts said. "We're going to be here from now on."
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