San Diego Hospice—Update

Last week, San Diego Hospice announced it will close in the next 60-90 days.  Efforts are underway to ensure continuity of care for their current patients.  A [substantial] portion of its assets will be auctioned off; Scripps Health has made a “floor” bid of $10.7 million.   But it looks like as many as half of the remaining employees will be laid off.  There is reluctance on the part of potential buyers to just purchase the hospice in its entirety, because the size of the liability is unknown (as I noted last week).

Let’s hope that good palliative care becomes increasingly established as good medicine wherever it is needed, and that third-party payer rules don’t squeeze it as it (and some patients, by extension) get better.

Worth reading is the San Diego Union-Tribune’s story about Dr. Doris Howell, the founder of San Diego Hospice.

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Susan Haack
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Susan Haack

When hospice care became a Medicare benefit, a philosophy of care was replaced by business rules and regulations–and the need for efficiency. But neither living nor dying are efficient processes. Moreover, care and efficiency make for odd bedfellows, for how does one care “efficiently”? While hospice cannot operate without money, it is regrettable that payors insist on being “governors.”

Jon Holmlund
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Jon Holmlund

A bit more on this. Again, I agree with the central point that an artificial rule (6 months life expectancy) militates against case-by-case judgment, and, heaven forbid, continuing care that is working and actually making the patient better. At least in the oncology literature, there is increasing talk about the benefits of “best supportive care”–emphasis on “best,” defined by physicians and distilled into guidelines for practice. The bright-line rules, which must be judged artificially and at a distance, are the problem. Even if the judges are “wise civil servants.” In the case of SD Hospice the battle is not over;… Read more »