Death Nurse: More on the dangers of for-profit corporate hospice

I’ve been observing for-profit-corporate hospice for a while, and have long believed it’s the single greatest threat to a patient and family’s opportunity to achieve a peaceful death

Ava Kofman’s recent piece emphasized yet again the need to develop ways to help people negotiate the minefield that for-profit corps have made of hospice, and to help patients, families, caregivers, clinicians and the community understand the difference between good hospice and predatory crappy hospice

There are so many rabbit holes in the space, as just one example:

Curo Health Services didn’t exist until 2010, when it was founded by some hospice sharpies and a private equity firm to acquire other hospices - classic rollup small players
2014 second PE firm buys Curo $730 million, first PE exit strategy
2018 third PE firm buys Curo $1.4 billion, second PE exit strategy
2022 fourth PE firm buys 60% of Curo + remains of Kindred Hospice for $2.4 billion, third PE exit strategy
Humana owns other 40% (they also love Medicare Advantage)

Like I said, that’s just one story there’s so much M&A going on because Boomers are getting old sick and dying - it’s a demographic wave

Surf’s up!

Working on the material also leads to the questions - so what? What can we do?

Here's what I think:

We need easy access to reliable information that supports informed decision making

“WE” = patients, families, caregivers, clinicians and the community

Every hospice must be required to post and update the following information daily, prominently on their websites, transmit it daily to the hospice compare section at medicare.gov, and be prepared to convey by phone when requested:
Post ownership
For-Profit must include parent corp, whether public/private, list PE & major shareholders, and post links to investor info
Not-for-Profit must post links to past 5 years IRS 990
Post ADC (total, home, LTC, ALF, other)
Post staff #’s (FT - RNCM, MSW, SC, HCA, NP/PA, MD, Other; PT - RN, MSW, SC, HCA, NP/PA, MD, Other)
Post actual case load # and average case load calcs @ NHPCO 2010 workload guidelines
Post staff #’s open positions
Post current quality scores
Post notice deficiencies & complaints
Post all staff bios