As a physician at a not-for-profit hospice, I am often asked what we do with the donations given to Hospice of Palm Beach County Foundation. Since standard hospice care is usually covered by the Medicare/Medicaid benefit or private insurance, physicians ask “what’s the difference between a for-profit and not-for-profit when it comes to patient care?”

 

There are a range of differences between the for-profit and not-for-profit setting in hospice including operational differences, the financial structure, innovation in clinical techniques and the range of services offered. As a physician, I have the privilege of seeing these administrative differences in action. The best way to summarize them is to outline real-life examples of donations at work, funding non-reimbursed services and allowing for a wider range of innovation and services.

 

Carl,* a middle-aged man with metastatic pancreatic cancer, wanted to go on hospice care at home. Yet, he needed to continue radiation treatments in order to relieve the intense pain of his tumor. While traditional hospices would not admit Carl, we’re one of 4% of hospices nationwide that would help. Since 2005, we have admitted many patients like him who need complex treatments for comfort, such as radiation, chemotherapy, transfusions and IV medications.

 

The Robinsons, a family with no financial resources, wanted their child with multiple disabilities to die at home rather than in the hospital. We were able to bring their child home and provide a complex and compassionate removal of life support, a process that includes not only a physician and a nurse but a social worker and a music therapist to help ease the family into this final transition.

 

Miriam, an elderly woman, had a primary diagnosis of ovarian cancer with malignant ascites, which made it difficult for her to eat, breathe or turnover in bed. Eventually, Miriam developed pneumonia. We inserted a Denver catheter to relieve the malignant ascites and taught her how to remove the fluid in her abdomen at her own discretion. This allowed her to eat and breathe more comfortably, significantly increasing her quality of life.

 

Sharon, a young woman in her twenties, needed a heart transplant but was not a candidate. We were able to manage her nestritide pump during the 6 months she was under our care. We even taught her mother how to change the bags, allowing her to travel to another city to visit a close friend. Our organization is a pioneer in cases like these, dating back to 2002.

 

There are thousands of families like these each year. As a not-for-profit hospice, our philosophy is simple: to do whatever it takes to offer everyone in our community the comfort, compassion and dignity they need during their final months. Thanks to the support of that very same community, we can make that possible.

 

Financial Statistics:

• For $15 per day, we can provide medication for one patient

• For $155 per day, we can provide end-of-life care to one indigent patient

• For $175 we can provide in-home assistance for one 8-hour day for one caregiver

• For $300 per day, we can provide one day of palliative chemotherapy for a patient