how to choose hospice why management

Wednesday, March 09, 2005

How to Choose a Hospice: Why management matters

(This is part three of a series on how to choose a hospice. To start from the beginning go here.)

Part three is an easy follow up question to the one you asked in part 2. Now that you know who owns the company, you need to know how many offices they have and where they are. Assuming that the company you are talking to is owned by someone who actually lives in your state, you now need to know if the owner works out of the office you will be working with.

You need to understand three things to understand why this question is important. First, most states limit how much territory any one office can cover. My office is allowed to admit any patient that lives within 50 miles of the office in any direction. If it is 51 miles to your house, I can’t help you. To expand the area that a hospice can cover all you have to do is open a branch office. Each office has its own 50 mile radius, so by opening a branch 49 miles from the home office you can serve patients 99 miles from the home office. You want to work with the home office. The nurse at the home office has direct access to the person who makes the decisions. Branch offices rarely have any employees who make business or financial decisions. Those offices are only staffed with clinical employees who must call the home office to get answers to business related questions, which leads to the second thing you must understand.

It is easier to be mean or heartless over the phone than it is face to face. If a nurse walks into the Administrator’s office and asks for something that is good for the patient but bad for the checkbook and the Administrator tells her no, then the Administrator will have to look her in the eye every day knowing that she thinks he’s a greedy heartless SOB. If the nurse calls from an office that the Administrator almost never visits and asks the question, then he don’t have to worry as much about dirty looks or lost respect of a coworker. The more detached the bean counter is from the patient, the easier it is for the bean counter to lose perspective of what is important. I meet many of the patients from our home office, but would rarely meet a patient from a branch office.

Third, you must remember that the cream rises to the top. The top is always at the home office. The head nurse at the home office is always the boss of the head nurse at the branch office. As a nurse gains experience they are naturally going to gravitate toward the home office. I’m sure there are exceptions to this rule but generally the home office is going to have better staff than the branch office. If you are choosing between two hospices and one is a home office and the other is a branch, choose the home office.

All right, I promise that I’ll get off my anti-corporate hospice bandwagon for the next post where I’ll discussion location, location, location.

There are six more parts to this series. Next, find out why location matters.

2
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