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HOSPICEAwarenessOctober 2012

Hospice of San Joaquin Opens First Hospice Office

in Manteca

Board ofDirectors

Gayle Riley, R.N., MPHBoard PresidentNurse, HealthcareAdministrator

Chris McCaffreyBoard Vice-President Vice-PresidentMorgan Stanley

Lou Meyer Treasurer

Retired EMS Executive

Leandro Vicuña, J.D.SecretaryVP, Sr. Trust & Investment OfficerCommunity Bank of SJ

Edward G. SchroederImmediate Past-PresidentPresident & CEOO’Connor Woods

Officers:

Members:Jaqueline Bagatta, RN

Deputy Director SJ General Hospital

Scott Beattie, JD, LL.M. Beattie & Aghazarian, LLP

Sabrina Schneweis-Coe, EsqAttorneyDowney Brand, LLP

Rev. David BennettSenior Pastor at CentralUnited Methodist Church

Pat Collier, RN, MSDirectorCommunity Health, SJMC

Barbara Galgiani, CPCU, CIC, CRM

Ins. Broker & Risk Mgr

Gary Giannini, CPA Principal Schwartz, Giannini, Lansberger & Adamson

Jack Gilliland, MD

Retired Pediatrician Margo Kozina

Teacher St. Mary’s High School

Evia Briggs Moore, Ed.D.Retired College Administrator

Kelly Stump, RN, MSNHospital SupervisorSt. Josephs Medical Center

Stephen Guasco Executive DirectorHospice of San Joaquin

Professional Staff:Robert T. Browne, MD

Medical Director Emeritus

James Saffier, MDOn-Site Medical Director

Mobin Ghavami, MDStaff Physician

Rebecca Burnett, RN, BSN, CHPN

Dir. of Clinical Services

Kerrie Biddle, MBADir. of Finance

Barbara Pombo, MBA Dir. of Development

Gene Acevedo, MBA Dir. of Comm. Outreach

Pam Byrne, Ph.D, RNTransitions Prog. Mngr.

Audrey Wuerl, RN, BSN, CHPN , Education Coord.

Carolyn Gomes Events Coordinator

Cheryl Berglund, RN, Hospice House Mngr

Becky Freeman Volunteer Manager

Carrie M. Lane, M.Div. Bereavement Manager

Patty A. RieberHuman Resource Mngr

Leo RonquilloInformation Systems Mngr

Allan SullivanChaplain

Ulmer Photo (Tim Ulmer)Volunteer Photographer

The Mission of Hospice of San Joaquin, a not-for-profit organization, is to provide comprehensive and compassionate medical care, counseling and support to terminally ill patients and their families, regardless of ability to pay, and to educate and collaborate with health care providers and the public in promoting quality end-of-life care.

Hospice of San Joaquin is governed by a community Board of Directors and is recognized as a 501(c)(3) organization. Hospice of San Joaquin is licensed by the State of California as a Hospice Agency and is certified by the Centers for MediCare and MediCal Services to provide the Hospice Medicare /Medi-Cal Benefit. The Joint Commission has accredited Hospice of San Joaquin.

For more information or referrals, call(209) 957-3888.

Joint ComissionAccredited

Our Mission

A nonprofit agency serving the community since 1980

On Tuesday, October 17th, community members joined Hospice of San Joaquin’s p r ofe s s io n a l s t a f f a nd volunteers to celebrate the ribbon cutting of the new south county extension.

“We are happy to announce the opening of our new extension in Manteca,” said Executive Director Stephen Guasco; and he explained that, “having Hospice of San Joaquin’s team stationed in Manteca offers residents a nd t he i r ca r eg ive r s a prompt resource as illness t rajectories advance into their terminal stages.”

The new Hospice of San Joaquin’s Manteca extension is located in a central location at the corner of Main and Nor th St reets at 179 W. Nor th St ree t , Manteca , CA. In addition to having the first hospice office in Manteca, the new facility brings bereavement services, volunteer trainings, caregiver trainings, and other resources for terminally ill patients and their caregivers.

“The new extension will be the heart of service operations i n t he souther n cou nt y region; this new location represents the commitment by Hospice of San Joaquin to provide the quality end-of-life care our residents of Manteca and neighboring communities deserve,” said Gene Acevedo, Hospice of

3888 Pacific Avenue, Stockton, CA 95204-1953 • 24-hour main-line: (209) 957-3888 • www.hospicesj.org

3888 Pacific Avenue

Stockton, CA

95204-1953

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San Joaquin’s Community Outreach Director.

In addition to the visiting c o m m u n i t y m e m b e r s ; , Members from the Manteca Cha mbe r of Com me rce were present for the official r ibbon cut t ing and open house reception during the morning of October 17th.

Hospice of San Joaquin is a

nationally recognized leader in hospice services. The not-for-profit organization cares for hundreds of patients on a daily basis at no-cost to the patient or their families. Hospice of San Joaquin offers innovative programs to enhance the quality of care for people when cure is no longer an option. In

addit ion to pat ient care, the agency offers education programs for physicians and healthcare professionals, c a r e g i v e r e d u c a t i o n materials, cultural diversity programs for end-of-l ife care, and other resources. For more information about Hospice of San Joaquin call (209) 957-3888.

Reprinted with permission by the St. L0uis Post-Dispatchby Jim DoyleAugust 19, 2012

St. Luis — Breathing has become increasingly d i f f ic u lt for Je a n ne Lampe, who spends her days hooked to an oxygen tank.

Lampe, 79, has “end s t a g e ” e m p h y s e m a , but still lives at home in a sout h St . L ouis apartment. She’s visited twice a week by a nurse from Hope Hospice Inc., which also provides a massage therapist , a social worker, a chaplain and workers to help with showers and chores — all paid for by Medicare.

When the end comes, she’s resolved to d ie at home, on her ow n terms.

“ D e a t h i t s e l f doesn’t bother me, but emphysema is a crappy death. You’re basically gasping for breath,” she said. “When I’m ready to go, I want morphine and a margarita.”

Lampe is among a fast-grow ing number of patients locally and n a t i o n a l l y w h o a r e choosing hospice, which seeks to provide comfort r at he r t h a n a c u r e . Advocates say the trend holds great potential to hold down runaway U.S. health costs by steering end-of-life patients away from more expensive and aggressive hospital care. But the industry’s rapid grow th also presents

regulatory challenges to federal authorities c o n c e r n e d a b o u t unethical recruitment of patients and the cherry-picking of less complex but mor e pr of i t able cases.

The number of hospice patients on Medicare doubled to 1.1 million between 1998 and 2008, according to the federal Centers for Medicare & Medicaid Ser v ices. A not her e st i mate of hospice pat ients this year, from the National Hospice & Palliative Care Organization, put the number at 1.6 million.

“ W i t h t h e a g i n g population and many people suffering from chronic i l lnesses, the n u m b e r o f p e o p l e c h o o s i n g h o s p i c e h a s e x plo de d ,” s a id Melissa D.A. Carlson, an assistant professor at Mt. Sinai School of Medicine in New York. “As people understand hospice, they want more and more to stay at home with their family.”

And more and more health care providers want to get into t he bu r ge on i ng m a rk e t . About 58 percent of A me r i c a n s s t i l l d i e without hospice care, s a y s t h e N a t i o n a l Hospice & Palliative Care Organization, leaving ample room to grow the business.

A d e c a d e a g o , hospice care was a niche dominated by nonprofit organizations. But now at least two-thirds of

licensed hospices in the St. Louis area are run by for-profit companies, according to the state Department of Health and Senior Ser v ices. And about 80 percent of Medicare-certif ied h o s p i c e p r o v i d e r s enter i ng t he ma rket b e t w e e n 2 0 0 0 a n d 2009 were for-prof it f irms, according to a study published in June by Hea lt h A f fa irs , a Bethesda, Md.-based policy journal.

“ There’s obv iously mone y to b e made,” said Carlson, who co-authored the study.

In the big picture, advocates say, hospice offers more quality of life and dignity in death -- at much lower cost. In St . L ouis Count y, for instance, providers receive a daily rate from Medicare of $144.91 for each patient in ‘routine’ h o s p i c e c a r e . T h a t typically includes the cost of drugs, medical equipment, supplies, and nursing care, but not room and board.

B y c o n t r a s t , hospita l izat ion in an intensive care unit can cost upwards of $10,000 a day, including drugs, equipment a nd sta f f costs.

“It is a phenomenal benef it to the family members and the patient as well as the healthcare delivery system,” said Judy Alexander-Weber, pr e s ide nt a nd c h ie f executive of the Visiting Nurse A ssociat ion of Greater St. Louis, a non-prof it whose hospice workers visit residences and nursing homes. “It’s the most cost-effective way to manage end-of-life care.”

M A I N T A I N I N G CONTROL

Costs aside, many hospice patients choose that option out of a more fundamental desire to control their destiny and manner of dying.

Benny Davenport, 84, a former f light engineer

People Near Life’s End Choose Comfort

and Control

See - Many patientschoosing hospice

on Pg 3

Above: Fabian Perez, Hospice of San Joaquin Volunteer visits Curtis Frazier, in-home

hospice care patient.

During the morning of Wednesday October 17th, community members and members from the Mateca Chamber of Commerce celebrated the ribbon cutting ceremony and

open house of Hospice of San Joaquin’s Manteca Extension at 179 E North St., Manteca

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Message from the Director

By: Kathy Harden HSJ Volunteer

Five years ago I became a volunteer at Hospice of San Joaquin. Over that period of time I have been impressed with the growth and development of grief support services offered to the families who have lost a loved one. There are programs for adults, children and teenagers. Recently Hospice of San Joaquin also started a support group for survivors who have lost a loved one to suicide. I am proud to be able to be a co-facilitator of this group.

There are many groups for people who have lost a loved one but support groups specific for those of us who lost a loved one to suicide have been difficult to find. My husband chose to end his own life in 1987. There were groups in Sacramento and the Bay Area but nothing in Stockton. I never felt like I really fit in with generic grief groups and I finally chose to make the drive to see what a support group specific to surviving the suicide of a love one was like. I found that I had finally found a place to talk about how I felt with other people who were experiencing many of the same feelings I was having. For the first time since my husband’s suicide, I felt comfortable sharing my feelings.

Support Group for Families of

Suicide VictimsP r i n t e d i n t h i s i s sue

of Hospice Awareness is the recent St. Louis Post Dispatch ar t icle, “Many patients choosing hospice for end-of-life care.” The article is far reaching in its depiction of hospice care. Even though the article focuses on the St. Louis area, it is equally valid and per t inent here in the Central Valley. We believe that the information

imparted in the article is of such importance that we have asked permission to republish it here.

Part of the article focused on the financial benefit to stem “runaway U.S. health costs by steering end-of-life patients away from more expensive and aggressive hospital care.” While it is fact that hospice care is significantly less expensive than aggressive curative care, this, in my opinion is far less important than the many benefits hospice care has over futile aggressive curative care.

Several studies, published in major medical journals, show conclusively that patients receiving hospice care live longer and have a significantly higher quality of life than those terminally ill patients receiving aggressive curative care. One of the recurring themes of these studies has to do with the length of time a patient is receiving hospice care. The sooner a patient is admitted to hospice care the better the results in terms of life expectancy as well as quality. This fact is echoed time and time again from our patients’ families. One of the most frequent comments received from our families is “If only Hospice of San Joaquin provided care to our loved one much sooner ….. Let people know not to wait.”

The growth of for-profit hospices in San Joaquin County is consistent with article’s cited growth in the St. Louis area. Thirty-two years ago, not-for-profit Hospice of San Joaquin was established when a group of community leaders invested their time and money to create a service for San Joaquin County’s terminally ill patients. Today, three for-profit hospices have opened offices in the County with a fourth for-profit hospice to open soon. The article cites the for-profits’ possible patient “cherry picking” to maximize their profits. While I do not know the for-profit hospices’ business strategies, profit is clearly the central tenet of their business plans. This is not the case for the not-for-profits. We exist to serve the community according to the principles set forth in our Mission Statements. Any and all excess revenues must inure to the benefit of the communities we serve. Hospice of San Joaquin is proud that we provide in excess of $1.3 Million in annual uncompensated care. This value is derived not from billed charges but, strictly from the direct cost (exclusive of any overhead expenses) to provide the care for which no reimbursement is received.

It remains a patient’s right to choose hospice care when a life-limiting illness has been diagnosed. It also remains the patient’s right to choose the hospice that will provide that care. The time to discuss the option of hospice care is when a life-limiting diagnosis is rendered. As our patients’ families have stated time and time again, “Let people know not to wait.”

Sincerely,

Stephen L. GuascoExecutive Director Hospice of San Joaquin

October 2012

The stages of grief are the same for anyone who has lost someone they love, but there are issues that are specific to the loss of a loved one to suicide. Many of our friends and family are uncomfortable talking about the suicide and so they say nothing at all. Sometimes it seemed to me as though my husband never existed at all. He was no-one’s brother or son or husband or father or friend. It felt like the day he was buried he ceased to exist. When someone dies, the survivors often share their memories of that person. They laugh and they cry together. It helps us stay connected to the person we loved and keep the person alive in our heart and minds. With a suicide that often does not happen.

The guilt and anger when someone commits suicide are often much more intense. There are so many questions we want answered. “What could I have done differently so that this would not have happened?” “Why did my loved one choose to do this?” “Why did my loved one not know how his death would affect those left behind?” “Did he/she not love me enough to keep trying?” “What did I do wrong?” When guilt and anger overwhelm a person whenever he/she thinks of the person who died, it is very hard to process the grief. The guilt and/or anger can be so intense that the survivor does whatever they can to avoid even

thinking about the suicide. At the same time the suicide is there all of the time and the thoughts of how the person died never leave your mind.

Grief must be felt and processed in order to get to the other side. I felt like I was in a black tunnel and there was no way out. Day after day and week after week, the weight of that darkness pressed down on me like a heavy weight until I felt like I could not possibly bear even one more hour of it, but I kept going back to that support group even when I didn’t feel like it. We were all different but in many ways we were the same. That group allowed me to work through my grief and eventually there was a pinpoint of light in that dark tunnel. It wasn’t much but it was there and over time it got bigger and brighter. I remember clearly the day I woke up and felt totally different and I realized

that I was still sad but I no longer felt guilty. It was like a terrible weight had been taken off of me. From that day forward my way to the end of the tunnel was much faster.

P e o p l e w h o h a v e survived the suicide of their loved one often say that things will never be the same again and they are right. Things will never be the same again. The person will never come back and the fact that they chose to end their own life will never go away. In spite of that, things will be good again. There will be happiness and laughter and happy memories of the time you shared with your loved one. For me the support group for survivors made a tremendous difference in the journey. I hope that the support group at Hospice can offer that same experience to other people who are experiencing the loss of a loved one to suicide.

Barbara Galgiani Vice PresidentCapax-Giddings, Corby, Hynes Insurance

I n r e s p o n s e t o t h e question, “What does your association with Hospice of San Joaquin mean to you?”, Barbara responds without hesitation: “Second to my family, it is the most important thing in my life. As a volunteer for this organization, I get so much more back than I give; the satisfaction of knowing that we make a difference for people when they need us the most is priceless.” Barbara Galgiani traces her connection to May of 2001 when her Mother died peacefully in hospice care. A year later Barbara called Hospice of San Joaquin’s Volunteer Coordinator, asking how she could help. Learning that ‘a group of ladies was putting together a Tea’ to suppor t t he building of the Hospice House, Barbara was quick to volunteer. The Tea of 2002 became the event that launched the Butterfly Auxiliary. Hospice of San Joaquin Butterfly Auxiliary was chartered in October 2002. Barbara has filled many chairs, including President of the Butterfly Auxiliary (now Stockton Chapter), Chai r of the Champagne and English Tea and Co-Chair of the Moonlight Sip ‘n Stroll. She has witnessed the growth of the Auxiliary in Lodi and Tracy, each now with active Chapters. Barbara and her husband John Galgiani are both donors and volunteers.

“I look forward to serving in another capacity on the Board of Hospice of San Joaquin and its working committees.”

Pat Collier, RN MS Director of Community Health Program, St. Joseph’s Medical Center.

When asked ‘what is it that drew your interest to Hospice of San Joaquin, Pat Collier gives a brief overview of her nursing career: “At St. Joseph’s Medical Center for 36 years; 16 of those serving in Home Health Care, 10 years as Director, I became very aware of hospice services. I am probably the only one that you have met who has a picture of Elizabeth Kubler Ross (author of Death & Dying, early hospice care educator) on the off ice wall.

“ I n t he he a l t h c a r e profession, our patients dying is something we still haven’t adequately

addressed in training our professionals. How to let people die, when it is their time; being there for people who are dying. I have been interested in hospice care for a long time. After my Mother died last year, I sought a way to actively serve with Hospice of San Joaquin.”

Sabrina Schneweis-Coe, Esq., Downey/Brand Attorneys, LLP, Stockton

Sabrina is part of her f irm’s Trust and Estate practice group and is a Certified Specialist in Estate Planning, Trust and Probate Law, by the California State Bar. Sabrina is dedicated to helping families plan for and transition through life’s ups and downs. She provides comprehensive, h i g h l y p e r s o n a l i z e d counsel in estate planning and special needs. She is a graduate of California State University and University of the Pacific, McGeorge

School of Law. Sabrina is well aware of

the services provided by Hospice of San Joaquin: “Personally, the family has used the services a number of times over ten years. Every time – it is like God-send. Your staff – they are wonderful;love your organization.”

Sabrina and her husband Da r ren Coe have t wo children, a 13 year old son and 10 year old daughter. “I’ve been interested in helping for awhile and my kids are now old enough. Their Dad now takes the lead in get ting them to their many practices and games. I am very happy to be joining the Hospice of San Joaquin Board. .”

Hospice of San Joaquin Board members are elected to three year terms which may be renewed for an additional consecutive term. Each member also serves on one or more working committees.

Hospice of San Joaquin Board of Directors

Welcomes New Members

ArmsA safe and understanding place for those who are grieving the loss of a loved one by suicide.

Reassuring

Care

A place to connect with others who are experiencing the same kind of grief, questions, hurts, struggles

A place to freely and openly share and explore feelings and experiences about the death

Meetings are scheduled the second Monday

of each month

5:30 to 7:00 p.m.

Cost is FREE however, pre-registration is required for EACH group; simply call HSJ Bereavement Services at (209) 957-3888. Please visit our web site for complete listing of group dates. www.hospicesj.org

Arms Reassuring Care

Call for Support(209) 957-3888

Barbara Galgiani, CPCU, CIC, CRM

Sabrina Schneweis-Coe, Esq.

(209) 922-0380

Season of Gratitude Fall Tea

Hospice of San JoaquinButterfly Auxiliary - Tracy Chapter

Saturday, Nov. 10th 2 – 4 p.m.Seating limited: call for reservations

Pat Collier, RN, MS

▪

Many patients choosing hospice:

the Next Level of Care

October 2012

Did You Know?Hospice of San Joaquin is Joint Comission Accredited. The Joint Comission’s vision is that all people always experience the safest highest quality, best-value health care across all settings.

Tree of Lights 2011 Remember Your Loved Ones

During this special season, honor or remember a loved one through Hospice of San Joaquin’s “Tree of Lights”. Your gifts directly benefit patient’s quality of life

Please print

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Street:

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e-mail:

Select a light Color Select a location Red Green Blue White Yellow Treetop Friends of Lights

$ 5 $ 10 $ 25 $ 50 $ 100 $ 250 $ 500

Stockton: Lockeford Lodi Tracy Galt Rio Vista Manteca

Please Print:

In MEMORY of:

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Check enclosed and completed form mailed to: Hospice of San Joaquin Tree of Lights

3888 Pacific Avenue, Stockton, CA 95204 (209) 957-3888

Please charge my donation to MasterCard Visa Am Ex Discover Credit Card #

Name on Card: Exp Date: Signature:

Or, visit our website to make your gift online

If your gift includes more names, download form online

a n d a u t o m e c h a n i c , resides in St. Charles Count y w it h his w i fe Martha — and wants to keep it that way unti l his death. SSM Hospice is helping his wife take care of him as his lung cancer spreads through his body.

“I want to clone my nurse,” Davenport said. “I’m as happy as I can be.”

In the St. Louis region, hospice care is growing a n d b e c o m i n g m o r e competitive. Smaller for-profit firms like Ballwin-based Hope Hospice and nat iona l cha i ns such as Miami-based Vitas Hospice Services have e nt e r e d t h e m a r k e t , competing for patients against local non-profit heavyweights like BJC Healthcare, SSM Health Care, and Mercy Health.

L a r g e r n o n p r o f i t health systems such as BJC Healthcare enroll many hospice patients at their own hospitals. Smal ler and mid-size operators, who claim they offer more individualized care, compete to recruit hospice patients before admission to a hospital.

B JC Hospic e le ad s the local market, with a b o u t 16 p e r c e n t o f hospice admissions. BJC’s “Wings” program helps children who have had long-term hospital stays move to home care and supports the family after the child’s death.

L oca l ly, demand is driven in part by local demographics. St. Louis is ranked No. 5 in the nation in the number of adults per capita ages 65 and older, and No. 10 nationwide in the per capita number of adults 65 and older who live alone, according to the “2009 American community survey” by the U.S. Census Bureau.

The state of Missouri h a s m o r e t h a n 1 0 0 l i c e n s e d h o s p i c e providers, and about 25 of those serve the St. Louis area. It also allows dozens of unlicensed hospice providers to do business, if accredited by professional organizations. Typically, hospice care is delivered in homes, hospital rooms, nu r s i n g h o m e s , a n d assisted living facilities.

I n M i s s o u r i , t h e average length of stay for hospice patients is 79 days, according to the state’s 2011 report on hospice prov iders. But about 28 percent of hospice patients statewide receive this care for less than seven days. At BJC Ho spic e , t he me d ia n length of stay is 11 to 14 days.

Greater use of hospice by terminally-ill patients, advoc ate s say, wou ld improve quality of life and help save Medicare funds for future generations.

Hospice is “the best, w e l l - r o u n d e d c a r e because you have all the disciplines involved,” said Jane Moore, executive director of the Jefferson C i t y- b a s e d M i s s o u r i Hospice & Palliative Care Association.

Helen Cassidy, director of Mercy Hospice, said that as a nurse she grew tired of seeing people die in the hospital without the

comfort of loved ones and familiar surroundings. “When it’s your own home, you maintain control,” she said. “For dying people, it’s important to maintain control.”

Wa l t e r S a nde r s , a cancer patient who will turn 80 on Wednesday, has been in hospice care with the Visiting Nurse Association since June 15. The retired Continental Can worker lives in south St. Louis with his disabled son, Gary, 55.

“At home, you have more freedom,” he said. “If I want to go out in the yard and sit I can do that. I can look at my flowers.”

CHERRY PICKINGT he r u s h i nto t he

hospice ma rket place, h o w e v e r, h a s r a i s e d concerns from regulators, i n v e s t i g a t o r s a n d ac adem ic s ab out t he potential for unethical operators.

Carlson quest ioned w h e t h e r f o r - p r o f i t hospices may be “cherry pick ing” their mi x of patients to increase their profits.

“A longer length of stay is more profitable for a hospice,” Carlson said. “They tend to have patients with non-cancer diagnoses … My guess is that they aggressively seek out patients with other diagnoses.”

A study published last year in the Journal of the American Medical A s s o c i a t i o n f o u n d that for-profit hospice prov ider s were more likely to have patients who require less complex, less costly care — but stay longer in hospice.

The study found, for instance, that for-profit f i r m s h av e a h i g he r proportion of patients residing in nursing homes. These patients are more likely to have dementia, w h i c h m e a n s t h e y probably will live longer but have fewer needs than cancer patients.

A n o t h e r s t u d y , publ ished in 2010 by the Journal of Palliative Med ic ine, found t hat for-profit hospices often employ lower proportions of more highly qualified staff, such as nurses and medical social workers, than nonprofit hospices.

The national hospice association has proposed federal legislation that

wou ld re qu i re s t ate s to perform surveys, or periodic inspections, of hospice providers every three years. Faced with a budget crunch, Missouri regulators have cut back surveys from every three to every five years.

Lisa Coots, director of the bureau of homecare a n d h o s p i c e f o r t h e Missour i Depar tment of Hea lt h and Senior Ser v ices, decl ined to comment.

Fe der a l reg u lator s have voiced concerns that some hospice providers are paying kickbacks or offering other financial inducements to entice nursing home directors or their staffs to refer patients to hospice care.

Last year, the federal Office of Inspector General b e g a n i n v e s t i g a t i n g h o s p i c e m a r k e t i n g practices and the business relat ionships between hospice providers and nursing homes.

T h e p r o b e w a s prompted in part by a repor t to Congress in 2009 by the Medicare P a y m e n t A d v i s o r y C o m m i s s i o n , w h i c h found that hospices were aggressively “trolling” for patients in nursing homes a nd u si ng ma rket i ng materials that did not use terminal illness as a Me d ic a r e c over a ge requirement.

Some large hospice providers in the St. Louis area have of fered free lunches, ice cream, and part-time nursing labor to lure nursing home directors and staff to refer patients for hospice care, said Laura Bilbrey, vice president and cofounder of Hope Hospice, whose employees visit patients in homes and nursing facilities.

Nationally, there have been at least four major prosecutions of hospice p r o v i d e r s t h i s y e a r involving allegations that they submitted Medicare claims for patients who were not terminally ill.

Odyssey HealthCare Inc., a nat ional chain owned by Atlanta-based Gentiva Health Services Inc., agreed in March to pay $25 mil l ion to sett le a l legations that it f raudulent ly bi l led Med ic a re for hospice ser v ices. Odyssey has local offices in Maryland Heights.

“Cho o s e c a r e f u l ly.

D o you r home work ,” s a i d G a i l B a r w i c k , patient coordinator for the nonprofit Fern and R u s s e l l F. de Gr e e f f Hospice House, which is located on the campus of St. Anthony’s Medical Center. “All the clients in hospice at some point become vulnerable. Not everyone appears to have the same code of ethics.”

S I X M O N T H S T O LIVE

A patient can qualify f o r h o s p i c e c a r e i f physicians certify that the person’s life expectancy is six months or less and the patient agrees not to pursue a cure.

But hospice patients can rescind that choice at any time, and a few decide to leave hospice and seek more aggressive treatment. Others leave hospice simply because they get better under the care they receive.

M e d i c a r e d o e s not l imit the number of ho spic e d ay s . But hospice providers must periodically document that a patient is continuing to decline.

T h o u g h p a t i e n t s increasingly are turning to the hospice option, many doctors remain reluctant to refer patients to hospice care. To some, it represents giving up.

“Doctors are taught to save people, not to let them die. Putting someone on hospice is a failure to them,” said Bilbrey, of Hope Hospice. “But what they don’t realize is that all that time the patient spent in t he hospita l could have been spent with the patient’s family, spending some quality time — letting that person die with dignity.”

Lampe, the ret ired nurse in hospice care, is taking the time to make end- of- l i fe de c i s ion s and say goodbye to her two grown children and f ive grandchildren. In a pinch, she can press a button on her wristband to summon help from Hope Hospice, rather than calling ‘911’ and be taken to an emergency room.

She has certainly seen better days. But given her current options, she can’t think of a better way to go.

“I’m totally spoiled,” she said. “I love it.”

Hospice Awareness is a bi-monthly newsletter published by Hospice of San Joaquin located at:3888 Pacific Avenue, Stockton, CA 95204(209) 957-3888 • www.hospicesj.org

Gene Acevedo, Director of Community Outreach: EditorBarbara Pombo, Director of Development: Co-EditorHSJ Professional Staff: Article ContributionsBilingual Weekly, LLC, Design & LayoutTim & Sue Ulmer, Ulmer Photography, ulmerphoto.comHeader Photo: Stockton waterfront by Monica Andeola, www.texmexphoto.como

Comments, questions, sponsorship opportunities or if you wish to be removed from our mailing list, please contact our office at (209) 957-3888.Visit our website for more information about Hospice of San Joaquin, www.hospicesj.org

Tree of Lights 2012 Remember Your Loved Ones

During this special season, honor or remember a loved one through Hospice of San Joaquin’s “Tree of Lights”. Your gifts directly benefit patient’s quality of life

Please print

Donor’s Name:

Street:

City:

State:

Zip:

Phone:

e-mail:

Select a light Color Select a location Red Green Blue White Yellow Purple Orange Treetop

$ 5 $ 10 $ 25 $ 50 $ 100 $ 250 $ 500

$1,000

Stockton Lockeford Lodi Tracy Ripon Rio Vista Manteca

Please Print:

In MEMORY of:

In HONOR of:

Send Notice of gift to:

Street:

City:

State:

Zip:

e-mail

Check enclosed and completed form mailed to: Hospice of San Joaquin Tree of Lights

3888 Pacific Avenue, Stockton, CA 95204 (209) 957-3888

Please charge my donation to MasterCard Visa Am Ex Discover Credit Card #

Name on Card: Exp Date: Signature:

Or, visit our website to make your gift online

If your gift includes more names, download form online

www.hospicesj.org www.hospicesj.org

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Upcoming Events

Copingwith the Holidays Saturday Nov. 10th9:00 AM to 12:00 noon

Wednesday, Nov. 14th5:00 PM to 8:00 PM

Designed for families experiencing the holiday without a loved one.Event scheduled at Hospice of San Joaquin’s Administrative Building located at 3888 Pacific Avenue, Stockton, CA

Must pre-register at (209) 957-3888

Butterfly Aux.

Poinsettia SalePlace your order by November 19thDuring the month order your poinsettias in time for delivery during the Holidays,Cost: $10-$30 Proceeds benefit Hospice House. For more information call(209) 922-0380

Volunteer Training Save the date for March 5 to March 29Mondays and Thursdays6:00 to 9:00 PMContact Becky Freeman, Volunteer Coordinator(209) 957-3888

October 2012

Tree of

LightsTracy — Tree of LightsFriday, Nov. 16, 20126:00 PMTracy Outlets1005 E. Pescadero Ave.City of Tracy

Stockton — Tree of Lights Tuesday, Nov. 27, 2012 6:00 PMSan Joaquin Delta College5151 Pacific AvenueCity of Stockton

Lockeford — Tree of LightsWednesday, Nov 28, 2012 6:00 PMPreceding the Cowboy Craft Faire19000 N. HWY 88City of Lockeford

Ripon — Tree of LightsFriday, Nov. 30, 2012 6:00 PMMistlin Park, East Main Street and Oak AvenueCity of Ripon

Rio Vista —Tree of LightsSaturday, Dec. 1, 2012 5:30 PMRio Vista at City HallOne Main StreetCity of Rio Vista

Manteca— Tree of LightsWednesday, Dec. 5, 2012 6:00 PMManteca Doctor’s Hospital 1260 E. North Street City of Manteca

Lodi — Tree of LightsThursday, Dec. 6, 2012 5:30 PMLodi City Hall221 W. Pine Street City of Lodi

PhotoIn-Review

(Below) Hospice of San Joaquin professional Staff and Volunteers pose with the 2012 Camp Caterpillar participants. Camp Caterpillar is a day camp

experience for grieving children. JOIN THE TEAM Volunteer at Hospice of San Joaquin

Volunteer TrainingMarch 5th to March 29th, 2012Monday & Thursday Evenings

6:00 to 9:00 pm

For further information or to register, callthe Volunteer Coordinator at

(209) 957-3888

Experience the rewards and satisfaction of making a difference in the lives of others

(right)Stephen Guasco, Executive Director of Hospice of San

Joaquin shares the agency’s history following the 32-years

of service as he introduced the Galaxy of Compassion - an invitation to bring the

light and comfort of hospice and bereavement to the next

generation. The event was hosted at Scott & Kathy Beattie’s

residence during the evening of October 11th.

(Left)Rebecca Burnett, BSN, RN, CHPN, Director of Clinical Services at Hospice of San Joaquin receives a donation from the San Joaquin County Sheriffs Association Golf Tournament. Presenting the Donation were Lieutenant Delanie Pimentel and Investigator Brian D’Acorn. The donation was in honor of Jack Nayer, DA Investigator.

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Photo by: www.ulmerphoto.com

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