Hospice to lose funding
A&E Hospice must find new care for patients after Dec. 5
Last Modified: Friday, November 14, 2008 at 11:17 p.m.
FLORENCE - The Centers for Medicare and Medicaid Services will stop funding A&E Hospice in Florence on Dec. 5, a move that will force the facility to find new hospice care for its patients.
The action comes on the heels of a series of visits since August by members of the survey team from the Alabama Department of Public Health that culminated in a formal four-day visit in October.
Lee Millman, spokeswoman for the Atlanta regional office of Centers for Medicare and Medicaid Services, or CMS, said the termination of funding comes as a result of "A&E's failure to comply with the conditions of participation" in the hospice program.
Among the charges leveled against A&E in the surveyor's 26-page report are a failure to appropriately document patient care.
Rick Harris, spokesman for the state health department, said the findings are a "big concern."
"It's a dead give-away that the people in management are not looking at the charts," he said. "Nurses and caregivers will make charting errors because they are human. It's OK to correct these errors when you do it the right way, but when we see a lot of uncorrected charting errors, then it tells us that there's no systematic chart review going on with the provider, which tells us, in turn, that (management) has no idea what the staff is doing out there."
Although CMS has given A&E 30 days to relocate its patients and while the termination of funding process continues, Harris said there were no procedures in place to revoke the facility's license.
"It's not so much of an urgent matter because once they lose their funding they won't be able to serve many patients, if any," he said.
A&E applied for a hospice license in June 2001 and opened for business in February 2002. The facility is owned by Andy Eddins, who also owns A&E Medical. Eddins said he was notified of the action Nov. 6, one day after the information appeared in The Birmingham News.
"I've been through this kind of thing before, when I had errors, lots of errors to be corrected," he said. "I corrected them, and everything was fine, which is why I'm so surprised by this. But patient care wasn't an issue then, and it's not an issue now."
Eddins said he has notified the patients and their families about the issue, and he said he's sought employment for nurses and other health-care providers on the A&E Hospice payroll.
"We feel like we weren't given a chance to correct these mistakes," he said. "When (the surveyors) were here in October, I begged them to tell me what to do to fix this, and I got nothing."
Millman said there is an appeals process, one that can be taken up with an administrative law judge, and Eddins said he plans to pursue that option.
Although he has not formalized his request, he said it would be filed by next week.
From that point, the judge will have 60 days to make a decision. If A&E wins the appeal, the soonest it could reapply for funding with CMS would be mid January to early February.
Both Eddins and Harris agree, however, that the move by CMS and the action taken by the state health department are largely the result of an overabundance of hospices in Colbert and Lauderdale counties.
The region is served by more than a dozen hospices.
"And we just don't have that many sick people to support all of them," Eddins said. "But why should I be picked on when there are all these others?"
Harris said the volume of hospices comes down to reimbursements. It's one of the few areas in health care that can be profitable for providers.
"Get out your calculator and do the math," he said. "If Medicare reimburses $113 a day, and a hospice cares for just 30 patients, multiply that by 365 days a year and see what you get.
"That's a huge cash flow for a provider not giving housing or meals."
Michelle Rupe Eubanks can be reached at 740-5745 or michelle.eubanks@TimesDaily.com.
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Comments
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November 19, 2008 8:15:34 am
RE: Link
Edit bandito strikes again. um.. anyone ever heard of amendment uno! Money talks even when the people are silenced!!!
November 19, 2008 8:50:06 am
They deleted the thread? I hadn't noticed. Go figure. Just another reminder of the favoritism for their sponsors...doesn't matter that none of what was said was untrue or slanderous/libelous...wonder how long it will take for them to delete this one.So is A&E even trying to respond to the State on the matter or are they just going to admit they were wrong, take their hit and shut the doors? Is Eddins going to get to keep his pharmacy and medical equipment business or will their findings affect his other businesses as well? I know he's already paying back one set of "fines" and "monies he was overpaid" -- he's going to need income to pay back what was taken.
November 19, 2008 9:06:57 am
I agree DavidMich, money must speak louder!! The real shame is that hospice has been portrayed as a money making business. The real profit is in the ministry it brings to people. To the patients, their families, and to those of us who are blessed enough to provide care to the TERMINALLY ILL (those certified as having 6 months or less to live). However, as in other professions, there are standards of practice that must be followed. Hospitals go through joint commission, large industries go through inspections, resturants have health inspections, the list could go on. When these surveys are completed the company is told where they have fallen short of the "rules" and are given time to correct these deficiencies. The said company files a plan of correction and it is reviewed and then the surveyors may or may not ask for more revisions. Based on the managements compliance to said deficiencies determines whether or not a business is allowed to stay open. Management should know what its' employees are doing or not doing especially in health care. Hospice focuses on quality of life and comfort not in quantity of days the patient may have left and above all a true hospice never focuses on money. Only to follow sound business practices. To have money in the bank for hard economic times, higher gas prices, etc. in order to provide quality care to patients. Money that is spent providing medications, supplies and equipment for patients and the salaries of those qualified professionals who care for the patients. Also, there is money in the bank to help those who have no insurance or Medicare/medicaid. So ask your local hospice how much money they spend a year in indigent care. It might suprise you.
November 19, 2008 11:22:14 am
Thank you David/Mich for reiterating that we have First Ammendment Rights in this country. The press should know that better than anyone, wouldn't you think? h2oloo, you are so right. It's not about having money in the bank. Any sound business would do so, for "rainy days." It's what you do with money that matters. A hospice can choose to use their funds to take care of patients in the community who are indigent and have no means to care for themselves, or have access to hospice care, and take good care of their employees. Or one can choose to send indigent patients elsewhere, because they want paying patients. Or one could choose to build LARGE HOMES, lakes, and buy vacation homes for themselves. Wouldn't you like to see all hospices post how many indigent patients they take care of in a year's time? Then maybe we would see just where priorities lie within each agency in this city.
I'm glad that the State is surveying hospice agencies in Alabama. We need to see "which ones will be left standing then." I have a feeling it will be the ones with integrity, compassion and honesty. Of course, it will be the State of Alabama and Medicare that will decide that.
November 19, 2008 2:04:11 pm
Did any one mention a person's name that was not in the article? That is the fastest way to get one shut down.
November 20, 2008 6:28:16 am
No. there was a lot of opinions and facts stated so I assume someone complained the A & E was being dragged through the mud...well, if you don't put yourself near the mud puddle you won't get dragged through it...
November 20, 2008 7:48:44 am
Big Chief say A&E spend much money with Times Daily...
November 20, 2008 8:00:21 am
Maybe that's my problem. I've been near the mud puddle too much of my life.
November 20, 2008 8:31:37 am
Apparenlty a lot...will be a lot less now... Rowdy --
November 20, 2008 8:40:31 am
What is A & E going to do with all of those patients?
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