Hospice Industry Outlook – 2010 Report

According to leading financial analysts, the United States has endured yet another recession and is continuing to recover. Yet the health care industry, and in particular various hospice care services, continue to feel little impact from the economic recession.

In the first year of the recession, mild global decoupling created slight alarm but little real action. In the second year, a synchronized global recession caused economies to plummet, reaching the lowest point in decades. And, while the financial outlook for 2010 is uncertain overall, the hospice industry is slated for remarkable growth.

Likewise, the most recent edition of the National Home and Hospice Care Survey (NHHCS) indicates that the job turn-over rate is lower in the hospice industry than in any other health care related venue. Representing a continual thermostat of current trends in hospice and home health agencies, it includes all facilities which are certified or licensed for reimbursement through the Medicaid or Medicare programs. This is good news for hiring managers, who may feel a bit pessimistic about taking on new employees.

Financial Outlook

A recent report published by the Department of Health and Human Services indicates that reimbursement rates for Medicare and Medicaid hospice patients will increase, beginning January 1, 2010. And, while reimbursement rates for physician services will not enjoy these increases, corporations who serve this distinctive segment of the population will find maintaining their operational budget is less difficult with the additional revenue. Terry Pratt, acting director of the agency, indicated to all state agencies nationwide that the new rates will increase by 2.1 percent, despite provisions in Section 1814 of the Social Security Act, which allow for a decrease in rates in cases of economic recession or national emergencies.

These increases provide a certain degree of financial security to hospice corporations, as budget cuts, which seem to be an issue of concern for other government agencies, will not apply to Medicare and Medicaid reimbursements for end-of-life care. Those who are employed in the field can be assured of job security, while those who are seeking employment will find the door wide open for new positions.

Hiring Trends for 2010

According to several Hospice Employers that utilize the NSLPN.com Career Network for posting open positions, hiring trends in the hospice and home health industry will continue to increase throughout the first part of 2010. Since April 2009, the demand for professionals in the hospice industry has increased by 314%, despite the current economic recession. In addition, while other careers lost tremendous ground in overall economic growth and financial stability, the hospice care and related health fields remained strong, with remarkable, positive change.

The hospice industry is a venue which can provide a wide variety of jobs like no other. Because hospice care provides a different level of medical treatment than the traditional health services, virtually anyone can be hired for available positions. While a working knowledge of general health care and sanitary practices are necessary for the hands-on health care worker, others who provide services such as cleaning or emotional support to the family or patient are not required to obtain the same level of training. During the first quarter of 2010, it is anticipated that hospice care corporations will continue to hire new employees to meet these and other needs. These trends can be credited for new job creation as well.

Post-fellowship employment opportunities for individuals in the medical field are expected to increase during the first quarter of 2010 as well. According to positive increases in the number of new medical students coming out of doctoral or other training programs, more individuals will be seeking professional employment venues. It is anticipated that hospice industries nationwide will increase their staff by as much as 5.7%, with 1.4% of these jobs being executive level positions. These new positions will further increase the viability of hospice care and ensure adequate operations.

Administrative positions in hospice are expected to decrease in 2010, primarily due to new efficiencies in office equipment and technology. Speech-to-text software decreases the need for skilled typists, while high-speed Internet services, mobile communication devices, and cell phone browser applications allow current administrative assistants to work more efficiently. And while it is not expected that the administrative sector will lose jobs, new ones are less likely to be created or filled. Hospice nurses and care providers will continue to utilize mobile devices for administrative purposes, further reducing the need for in-office administrative assistants.

New Trends in Hospice Care for 2010

While profit margins continue to decline or stabilize and businesses tighten their belts, home health care corporations are revamping their expenditure-to-profit ratios in unique ways. Recognizing current changes in demographics, many agencies are creating new markets for the urbanizing and aging populations by opening new campus facilities. Building and operating environmentally-friendly businesses and hospice facilities have resulted in massive financial savings while maximizing profit margins. Finally, finding unique ways to cut costs, such as offering internships to nursing or medical students, utilizing time management strategies, and gaining cooperation from civil and community service organizations continue to bolster the hospice industry.
New Hospice Facilities in 2010

Innovative expansions in the hospice and home health industry is anticipated to boost the overall financial outlook in the first quarter of 2010. While some companies continue to provide traditional in-home services, others are adding hospice wings to existing facilities.

The Cedars, an assisted living and nursing home facility in Monroeville, PA for example, recognizes the need for hospice services in the city and surrounding area. An $8 million addition to the existing campus is slated for grand opening in the early part of 2010. John Silvestri, a board member of the Monroeville Christian / Judea Foundation and manager of the facility, is thrilled to be a part of the expansion.

“We are opening an all-new, standalone facility, devoting an equal amount of space to patients and their families. Our mission is to provide health care at all stages of life. With the new addition, we will be able to continue this mission.”

Other live-in hospice centers are scheduled to open nationwide. A new addition to the Elwyn Medical Center of Philadelphia will open 36 new beds and rooms to disabled patients who cannot be adequately served by nursing homes, traditional group homes, or in-home care. Go-Ye Village, an assisted living apartment complex and nursing care center located in Tahlequah, Oklahoma, is adding four more buildings to their property, each dedicated to hospice care for various conditions. While one building may serve cancer patients, another may be dedicated to the victims of Alzheimer’s and their families.

Thousands of patients will benefit from these and other new facilities, which will provide these patients with comfortable living arrangements for the same or comparable price of nursing home services.
Green Hospice Corporations

Thanks to extensive public education efforts, scientific research, breaking glaciers, and obvious environmental damage, the average citizen can no longer deny the effects of “modern” consumption. The hospice industry recognizes that something must be done to stop the continual erosion of the environment. In order to meet these goals, numerous hospice corporations are turning their attention toward greener facilities, environmentally friendly business practices, and reducing carbon emissions. Likewise, with the undeniable consequences that will ensue if action is not taken, the trend toward greener, environmentally-friendly practices is expected to increase in 2010.

While including green products or services is nothing new, building entire new facilities that support the environment is a recent endeavor. The hospice industry is blazing a trail among conscientious businesses by including such items as low consumption water facilities, solar panels, wind turbines, organic and locally grown produce, recycled building materials, recyclable supplies, as well as installing energy-saving windows and appliances. As the going-green initiative stretches worldwide and into all sectors of the economy, more hospice and home health care corporations are jumping on the band wagon. And, while the price to construct such a facility costs about 2% more than the standard location, the financial savings can be as much as $100,000 in return, not to mention the reduced environmental impact.

Hospice of Northeastern Illinois is slated to open an all-new green hospice facility in Spring 2010. The new facility, which was architecturally designed to create a minimal carbon footprint in the surrounding woodland area, will include solar lighting, renewable energy sources, lush organic gardens, and numerous items made of recycled products. It is one of only a few all-green hospices around the nation.

“We recognize the need in caring for the whole person, and especially in the case of hospice patients,” says Carla Andrews, director of the new facility. “By providing opportunities to enjoy the crisp, clean air, engage in gardening, or simply basking in the sun, our patients can enjoy their final moments of life to the fullest, while doing something to save our planet.”

Other hospice companies have committed themselves to doing their part to support the environment in smaller ways. Safe Harbor Hospice of Fredericktown, MO has taken the carbon footprint issue to a higher level by including environmental awareness and recycling practices in every aspect of their business day. From energy conservation inside every office to recycling all recyclable products, the corporation sets the standard for doing business in an environmentally-friendly way. The old, gas-guzzling company cars have now been replaced with newer, higher MPG models. New appliances and water conservation facilities have been installed in all office locations. In addition, instead of traveling to various homes at random, hospice care service routes are now streamlined for optimal gasoline efficiency.

Amy Keller, director of clinical services and patient care, states, “I feel good about giving back to the environment and the community. Being active in this way is very important.”

Safe Harbor Hospice has made it their mission to reduce their carbon footprint while educating themselves and others about additional green behaviors.
Final Thought

An obvious shift toward traditional markets is apparent, in part due to uncertainty in the economic outlook for the coming year, and the hospice industry will continue to blaze a trail for new and innovative business venues throughout the first quarter of 2010. Subsequently, professionals, administrators, and executives in the and hospice and related home health sector should avoid unnecessary lay-offs, as finding good, reliable employees may prove difficult in the near future.

Sources:
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Department of Health and Human Services, Pub. 100-04, Medicare Claims Processing Manual, Chapter 11, Processing Hospice Claims, § 30.2.
Section 1814(i)(1)(C)(ii) of the Social Security Act, Payment Rates for Hospice Care

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