Medicare approval sought Carroll Hospice awaits evaluation

August 23, 1992|By Mary Gail Hare | Mary Gail Hare,Staff Writer

WESTMINSTER -- More than a year's work to get Medicare certification for Carroll Hospice hinges on the results of a three-day survey that will start Sept. 1.

On that date, a state inspector will begin to audit all the hospice records, including patient charts, financial reports and volunteer programs.

"The surveyor will be looking to see if we are providing the community with optimum services to the terminally ill," said Julie Flaherty, executive director of the hospice at 30 Carroll St. in Westminster.

The surveyor also will visit the homes of three patients -- who have signed a consent form -- asking if the hospice is doing "a good job," she said.

The work will be worth all the effort, she said. Once certified, the hospice can offer benefits for the terminally ill under Medicare, the federal health insurance program, to its eligible patients.

Since 1986, Carroll Hospice has helped families care for dying loved ones. Along with 100 volunteers, the small staff provides comfort, compassion and medical assistance, helping the terminally ill end their lives in dignity.

In the past year, financial constraints have impeded the work.

"We receive tremendous financial support from this community," Mrs. Flaherty said. "But our patient census continues to grow and our dollars don't."

The agency now relies on donations, memorials and a soon-to-end county grant. Fund-raising activities usually net about $100,000 a year, she said. That amount is not keeping up with the cost of caring for patients, who currently number 25, ages 35 to 85.

"More than half our patients have been ill for longer than a year, have maxed out their insurance benefits, and incurred huge bills they simply can't afford to pay," said Mrs. Flaherty, a registered nurse who has been hospice director for 13 months. "Medicare's hospice benefit is an avenue to more money."

Medicare, into which people pay all their working lives, will compensate certified hospices for patient services.

"We don't want to deny anyone services," Mrs. Flaherty said. "Federal intervention would allow us to provide core services to all our families."

The Medicare hospice benefit pays for all care and is designed to help patients stay in their own homes.

"Hospice will manage all the hassles and paperwork for the family," said Mort Foos, director of the Hospice of Prince George's County, which was Medicare-certified in 1988.

"One call from the patient to our office does it all," she said.

The money also allowed the Prince George's hospice, whose daily patient census is 55 to 58, to expand counseling, community education and bereavement support programs, Ms. Foos said.

"We can provide more services and enhance the services insurance doesn't cover," she said. "We don't have to turn

anyone away."

The hospice benefit pays fully for pain medication, comfort items and oxygen.

Patients who need services unrelated to their terminal illness can temporarily opt off the plan.

"The return is tremendous for a person whose life is measured in months," Mrs. Flaherty said.

Moving the office into "compliance with Medicare regulations" has been an exhaustive process, the director said.

The staff compiled a policy and procedures manual of more than 100 pages, detailing items from admission criteria to quality assurance.

"It provides a real A-to-Z detail of the entire operation," she said.

The state Department of Licensing and Certification will conduct the survey.

"Our department wears two hats," said Carol Benner, state director. "We license under state law. We also act as an agent for federal health care to certify that an agency is in compliance with federal law."

If the hospice passes inspection without deficiency, Medicare will immediately issue a provider number, said Mrs. Flaherty, and the agency can begin to bill Medicare for its services.

The 90-day reimbursement turn-around could make the remainder of 1992 "tenuous" for hospice, she said.

"We have several fund-raisers planned to get us through the lean months," she said.

Fund-raising activities will continue even with the certification.

"We still have to raise money for those not in the Medicare system," she said. "It's not unusual to get the 35-year-old uninsured patient."

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