Thursday, March 30, 2023

Updated Game Over Updated

Don't piss off the puppeteers

Time to throw this baby out

So I've been slowly making my way through this podcast, because like any good journal article there's a reason (need?) to stop at about every 6th word - either to check out a footnote that turns into a multi-day  rabbit hole, think about what you just read and read it again, or just mutter quietly WTAF?

Anyway, the only thing I can manage today is to reflect back on a phrase VITAS dude leaned into right out of the gate - "tax status" 


I just remembered something VITAS dude said in his first 10 seconds of the podcast - "tax status" - that's an important rhetorical misdirection on his part even if clumsy shallow Weaselspeak

Sure, one difference between not-for-profit and for-profit hospices is that the not-for-profit hospices are exempt from paying the IRS  because they're recognized as charitable entities, like your favorite local church

They have to state their case and show evidence - most notably by filing IRS Form 990 every year to report on their finances and operations, including how much the highest earners get paid

It's all very transparent - orgs have to make their filings open and available for public inspection, and legit orgs like Doctors Without Borders and Partners in Health make theirs available right from their websites

For whatever reason I haven't found any hospices that do the same, but online resources like Guidestar provide access independent of the orgs - though they may not be too recent

Plenty of non-profit hospices have reason to be hinky about their finances (exec comp and bonuses in particular), but at least with a little digging it's possible to get some idea

Here's the problem with VITAS dude's memorized propaganda - if the issue is simply one of "tax status," can you seriously imagine this conversion between VITAS godfather Don Gaetz (yeah, he's the dad) and his financial backers in 1984 when non-profit Hospice Care, Inc. became for-profit Hospice Care, Inc:

Don Don - We haven't been paying taxes since 1978, even though we've done a ton of business and now we're looking at even more business paid for by the federal government, the freaking sky is the limit!

Financial Rapscallions (in unison) - What should we do, Don Don?

Don Don - We should definitely start paying taxes!
Financial Rapscallions (in unison) - What a great idea, Don Don!! Yes, let's start paying taxes!!!

You guys crack me up. Please push back on the nonsense, it's literally the least you can do.


Note - I have deep respect for the GeriPal dudes that goes all the way back to the early days of blogging about this stuff, and even wrote a thang for them back in the day, as well as a thang about their thang in tribute

I'm glad they did this podcast, and also very sad because it shows how bleak the future of hospice is

Imagine yourselves as energetic go-getters from Toys R Us completely convinced that those dudes at Bain Capital will have a complete change of heart once they listen to what you have to say