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IN THIS ISSUE
COVER STORY, PG 1
LETTER FROM EDITOR, PG 1
CUSHMAN’S CORNER, PG 6
HOSPICE OF THE PANHANDLE,JOYS AND WOES, PG 7
HOSPICE NEWS & NOTES, PG 9
QUESTION OF THE HOUR, PG 10
CALL TO THE FIELD, PG 10
The FlutterBRINGING HOSPICE HOUSE PROFESSIONALS TOGETHER
Various Models ofFood Service Delivery
in Hospice Houses
One of the primary responsibilities of operating a facility for
ter-minally ill patients is food service. We all have to eat—even
if hos-pice-appropriate patients likely are eating less—and local
licensing requirements in this area can be quite specific. Even
when the pa-tient eats next to nothing, the ritual of serving food
is important in creating a homelike setting for care. But if you
are feeding your
A LETTER FROM THE EDITOR,LARRY BERESFORD The definition of a
Hospice House remains fluid, both within the hospice community and
for a larger health care system in flux. Distinc-tions between
residential and general inpatient (GIP)-level care, size, length of
stay, who will pay for the stay, how it is documented and
billed—these are some of the issues that highlight the diversity of
models even within our small community, the Hospice House Network.
And heightened reg-ulatory scrutiny only adds urgency to these
questions. A large hospice in Florida re-cently agreed to a $10.1
million pay-back to the government for inpatient
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The FlutterAugust 2015
Volume 4, Number 2
HopeWest’s Spoons Bistro and Bakery in Grand Junction, Colo.,
serves meals to the public from 7 am to 9 pm as a natural extension
of the hospice’s need to provide warm and healthy meals to the
patients in the 13-bed Hospice House Care Center upstairs.(See page
5.) Photo courtesy of HopeWest.
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residents, it may not be a great additional stretch to also
provide meals to their families, other visitors, staff and even, in
the case of an affiliated café, the larger community. Experienced
hospice architect and HHN member Tom Mullinax, founder and
president of Hospice Design Resource in Hilton Head, S.C.,
identifies four basic models of food service in Hos-pice Houses.
The first is a kitchen in a small fa-cility of fewer than 16 beds,
which doesn’t need to be commercial in size or quality of
equipment. “The only health department standards typically enforced
are for an ansul fire suppression system over the stove and a
dishwasher that can achieve 160 degrees.” This model works well for
preparing breakfast, which is often the main meal of the day for
Hospice House residents, Mullinax says. “Eggs, oatmeal, toast, or
pancakes, are quick and easy to prepare. Even bacon can be
provided, although for liability reasons, I would recommend using
the mi-crowave approach, rather than frying it.”
“Once the leap to a commercial kitchen is made, it typically
means the addition of a cook and leads to offering meals to
families and some visitors. Menus are typically larger.” -- Tom
Mullinax
Spoons Bistro and Bakery, a café located in the same building as
the Care Center of HopeWest, a hospice in Grand Junction, Colo., is
open to the public as well as supplying hot meals to hospice
patients. It earned a Certificate of Excellence for its hospitality
from TripAdvisor. Photo courtesy of HopeWest.
A second approach is food catered in from vendors, with a
warming kitchen to heat before distribution. “This is typically
limited to patients and, sometimes, families who order ahead of
time so you know the quantity of food to bring in, typi-cally with
a very limited menu.” Even if the facility is more than 16 beds,
this form of delivery needs very limited rewarming, plating and
cleaning capa-bilities—although it typically requires a triple bowl
sink and a separate handwashing sink, Mullinax says. In some
locales the health department also requires the use of a grease
trap, regardless of the kitchen’s size. “Facilities over 16 beds
that do not utilize catered food from outside are required to
provide a full commercial kitchen. Once that leap is made, it
typically means the addition of a cook and leads to offering meals
to families and some visitors. Menus are typically larger and the
food is typically better.” The fourth category includes a variety
of other approaches. Mullinax says he recently learned about a
hospital that has a cart that goes from room to room so that small,
limited meals can be prepared to order at each patient’s bedside.
This is very popular with patients, he says, but would require
consideration of fallback position for the commercial kitchen
design should the cart approach prove to be infeasible. “A hybrid
that we used in a facility in Bloomington, Ind., was pre-packaged,
frozen meals prepared, sealed, frozen and stored in a hospital
kitchen, transported to the hospice and held in freezers until they
are ready to be reheated and served,” he says. Patients could
select from a menu and the meals would be pulled, heated and
served. Families also bring food from home or take-out restaurants,
and family rooms or kitchens may
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COVER STORY, CONT. FROM PAGE 1
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www.hospicehouse.us August, 2015 2
https://www.ansul.com
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have a variety of resources for self-service meal preparation.
Hospice of the Western Reserve in Cleve-land, Ohio, operates two
Hospice Houses of 40 and 32 beds, each with its own self-operated
dietary services and personnel. “The two sites use the same food
services vendor and all menus, recipes, prac-tices and procedures
are the same, with an occa-sional slight variation specific to the
location,” says dietary services team leader Leslie Griffith, RD,
LD. A clinical dietitian completes a nutritional assess-ment for
all residents of the two facilities. All food is prepared onsite,
with food preferences, intoler-ances and allergies noted. “Hospice
of the Western Reserve uses a formal three-week cycle menu, which
offers a va-riety of selections for each meal.” Three meals are
served daily at set times, Griffith says. “For lunch and dinner,
there are al-ways two entrée choic-es. We focus on comfort foods,
but also include choices with an ethnic ap-peal. Our staff can
always prepare a grilled cheese sandwich, scrambled egg, fruit
plate or select soups not featured on the menu that day if there is
a special need.” In hospice care, therapeutic dietary restric-tions
are liberalized. Patients may be given half or quarter servings or
pureed consistencies, Griffith adds. “Our relationship with food is
a powerful thing, and we are cognizant of the emotional issues for
families attached to their loved one’s ability to eat. Sometimes
hospice’s challenge is to try to be sensitive to this transition in
dietary ability and to gently guide patients and families through
that transition.”
Family visitors also have multiple options, including cafes at
both facilities open daily for lunch with soup, salad bar, prepared
sandwich-es and snacks and vending options available af-ter-hours.
Both facilities also have family kitchens available for visitors to
use. “Hospice of the Western Reserve is partic-ularly proud of one
of our signature programs—Meal to Remember—available for patients
and their guests. Each month at each IPU, a different local
independent restaurant and its chef prepare and donate an entire
meal serving 80 to 90 peo-ple so that patients and their loved ones
can come
together around a table covered in fine linens and decorated
with flow-er arrangements created by our volunteers. The simple
comforting ritual of enjoying a family din-ner together or going to
a restaurant is an experi-ence that frequently gets lost when
coping with a serious illness,” Grif-fith says. (See photos on page
5.)“This program works with generous chefs in our local culinary
com-munity to bring back that meaningful quality
time,” she adds. “The meals are served on fine china. Donated
wine from a local wine merchant is poured. Volunteer pianists from
the community provide background music. Photos are taken and given
to patients and families as mementos of this special evening.”
HHN-member Hospice of the North Coast in Carlsbad, Calif., used to
contract for food ser-vice with a skilled nursing facility located
across the freeway from its six-bedroom inpatient home, Pacifica
House, but found after a year that most of the meals were getting
thrown away, reports Ex-
This Hospice House kitchen built for JourneyCare Hospice,
Barrington, Ill., was planned adjacent to “soft space” that could
be easily relocated to permit eventual expansion of kitchen
facilities. Photo by Tom Mullinax, courtesy ofHospice Design
Resource.
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COVER STORY, CONT. FROM PAGE 2
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http://www.hospicewr.org/news-events/events/remember
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days that were improperly billed to Medicare, although the
hospice points out that it uncovered the problem on its own of
insufficient documentation to support the GIP rate and voluntarily
self-disclosed to the govern-ment. And hospice compliance
consultant Mary Nester of Amboy, Wash., notes that some
Medicare-certified hospices can’t get access to GIP care because
the hospitals in their communities are unwilling to give them a bed
contract—a conclusion supported by the Office of Inspector
General’s discovery that 953 hos-pices provided no GIP care
whatsoever during calen-dar year 2011. “There are situations where
the most natural place to provide hospice GIP care is in the
hospital setting,” Nestor says, but hospitals have no legal
ob-ligation to contract with a hospice. The challenge is to educate
hospital administrators to consider it part of their service to
their community, she says. “Often the hospice hasn’t explained it
very well.” Better inpatient hospice options can contribute to the
hospital’s patient satisfaction scores and to the continuum of
services that will be required for participation in health care
re-form. Nester also encourages hospices to document their
conversations with the hospital to show the efforts they have made
to obtain inpatient contracts, and to consider the role of
collective advocacy to demand easier access to inpatient care for
all hospices. But if a hospital setting is unavailable and
in-vesting in a freestanding hospice facility or unit is not
feasible, then hospices are pretty much obliged to turn to skilled
nursing facilities. They are urged, however, to be selective about
the SNFs they choose to contract with for GIP—and to make sure that
a registered nurse is onsite to provide the care 24/7, says Meg
Pekarske, an attorney with the Wisconsin firm Reinhart Boerner Van
Deuren. “Given recent scrutiny of the medical ne-cessity for GIP,
the quality of the facility’s documenta-tion is a key
consideration. Likewise, it should be clear to the SNF that it is
expected to do something different while providing GIP than when
the facility simply pro-vides room and board,” she says. It has
been conventional wisdom for many hos-pice facility planners that
Hospice Houses are finan-cially viable only if they stick to
GIP-level care and bill-ing, eschewing residential care. Yet
Margaret Cogswell of Hospice of the Panhandle in Kearneysville,
W.Va., says on page 7 of this newsletter that the government’s
expectations for GIP level-of-care determinations have become
much stricter since she started planning her agency’s Hospice
House. She fully expected to fill the beds of her new facility with
GIP patients, but quickly found that if the hospice didn’t take
residential cases, the beds would go empty. Meanwhile, the social
model or “hospice home” has gotten national attention recently (see
page 9). Some HHN members provide this kind of care—often in
collaboration with Medicare-certified hospice clini-cal teams
responsible for the patient’s hospice care. This model requires
large portions of both community support and volunteer staffing.
But a facility designed around what the community and patients
need—rather than what is covered by Medicare—can sometimes in-spire
such support. A noteworthy example is a Hospice House for
terminally ill, homeless people in Salt Lake City, which had 300
volunteers before it even opened its doors. We’d like to hear what
you think about these variations on the definition of Hospice House
and whether residential and GIP care can comfortably co-exist under
one roof. Thanks for listening.
LETTER FROM THE EDITOR, CONT. FROM PAGE 1
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A family kitchen at Merrimack Valley Hospice House, Haverhill,
Mass., is designed for family members to prepare special meals for
their loved ones, with a commercial kitchen in the background
(above). The small kitchen (below) in the Hospice House of Hospice
of Southern Maine, Scarsborough, and its cook are in full view from
the dining room. Photos by Tom Mullinax, courtesy of Hospice Design
Resource.
https://oig.hhs.gov/oei/reports/oei-02-10-00490.pdfhttps://oig.hhs.gov/oei/reports/oei-02-10-00490.pdf
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The Flutter a publication of the Hospice House Network |
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ecutive Director Sharon Lutz. “Even if the patients ordered the
meal, even if they were on respite in-stead of GIP and had a
heartier appetite, they’d end up saying, ‘I don’t want to eat,’”
she relates. “What we ended up doing was to work with our
registered dietitian, who made us a week’s menu, including
ready-to-eat entrees of various fla-vors, grilled cheese
sandwiches, soups, green sal-ads—all based on high oral
gratification and easy to prepare. We also have jello, apple sauce
and fresh fruit. There is a substitute menu if a patient does not
have the appetite for what is planned. We also try to bake
something every day to enhance our warm, homelike atmosphere. We
have a patient kitchen where all of these items are prepared for
the highest food quality and safety.” The dietitian comes weekly,
and as new patients arrive, to work with them on nutritional
issues, diet modifications and special needs. On the other side of
the facility is the Great Room with a family kitchen offering
coffee, tea, milk, morning pastries and fresh fruit, with a fridge
full of drinks. “We don’t provide or charge for for-mal meals to
families. But they can bring in any-
thing from outside,” Lutz says. Stocking these food items costs
about $100 a month, and the facility’s clinical manager goes
shopping for them every Monday. “Staff in the facility will cook
something up as needed—depending on how busy they are,” she
explains. “My advice for other Hospice Hous-es: Keep it at a
minimum to start and develop your food service based on your
specific focus and needs. People have very different ideas about
what they want to eat.”
A Hospice Café Out West
HHN-member HopeWest in Grand Junc-tion, Colo., has taken the
food service function a step further with Spoons Bistro &
Bakery, a cafe open to the public from 7 am to 9 pm except
Sun-days, when it just serves brunch to the public, and offers
discounts for hospice families and staff. “There is a synergy
involved; it’s in the same build-ing as the Hospice House,” says
HopeWest senior vice president and chief administrative officer
Terri Walter. “We have an extensive menu inside the
Hospice of the Western Reserve’s Meal to Remember program (see
page 3) brings celebrated local chefs into its two Hospice House
facilities in Cleveland, Ohio, every month to prepare gourmet meals
served on linen tablecloths to the residents and their family
visitors (left). Below from left, a staff member from Crop Bar and
Bistro applies finishing touches to a dessert to remember at David
Simpson House. A menu from Paladar Latin Kitchen describes the
Latin American specialties served to hospice patients and families.
And a holiday meal prepared by Chef Rocco Whalen and staff of
Cleveland’s popular Fahrenheit restaurant is accompanied by dinner
music from a hospice volunteer. Photos courtesy of Hospice of the
Western Reserve.
COVER STORY, CONT. FROM PAGE 3
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Cushman’s Corner
What is the proper utilization of hospice inpa-tient care for
patients discharged from the hospi-tal? Many people with advanced
illness could really benefit from hospice inpatient care and
inpatient facilities following their hospital stay—but how many
have access to this special kind of care? Con-sultant Jay Cushman,
President of Portland, Ore.-based Health Planning &
Development, LLC, has dipped into the Medicare database to try to
get a clearer perspective on these issues. “One of the benchmarks I
have employed when judging the accessibility of hospice care for
hospitalized patients is the balance between patients who are
referred to hospice from a hospital and pa-tients who die as
hospital patients,” he says. “These statistics can be read directly
from a hospital’s dis-charge abstracts that give the counts of
patients by discharge status. The discharge status code for a
patient who dies in the hospital is 20, while the dis-charge status
code for a patient referred to hospice is either 50 or 51,
depending on whether the patient went home for hospice care or to a
facility.” Cushman defines the end-of-life (EOL) pa-tient rate as
the relative proportion of those dis-charged from the hospital
directly to hospice care
The Flutter a publication of the Hospice House Network |
www.hospicehouse.us August, 2015 6
Benchmarking the Utilization of Hospice Care Following a
Hospitalization
versus those who die in the hospital. “I find that when there is
excellent access to hospice care the balance of these counts is
around 70 to 30. That is, for every 70 patients who are discharged
(still alive) to hospice care, about 30 patients die in the
hospital. So I measure a ‘target hospice percentage’ as 70 percent
for EOL patients.” Overall, the average rate for EOL patients in
U.S. hospitals in 2013 was close to 50 percent (see the chart at
left). About 17 percent of the nation’s hospitals had hospice
percentages of 70 percent or greater, but 25 percent had hospice
percentages be-low 40 percent. “Conceptually, we want the EOL rate
of referral to hospice to be as high as reason-ably possible,” he
says. “Similarly, we want the per-centage of patients who die
without hospice care within six months of hospitalization to be as
low as reasonably possible. It is also possible to measure the
‘percentage of deaths without hospice’ using Medicare claims data,”
he says. “Where there is excellent access to hospice care, I have
found that the percentage of patients who die without hospice care
within six months after a hospitalization to be 40 percent or
lower. However, the average statistic for ‘deaths without hospice’
following a hospitalization in 2012-2013 was close to 50 percent.”
(See the chart below). For more information about these data,
contact Cush-man at: 503/636-3920 [email protected].
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The Flutter a publication of the Hospice House Network |
www.hospicehouse.us August, 2015 7
Hospice of the Panhandle...A Year Filled With Joys and Woes
For Margaret Cogswell, CEO of HHN-member Hospice of the
Panhandle in Kearneysville, W.Va., the first year of running a
Hospice House facility that opened in March of 2014 has been a
heady mixture of joy and woe. “We’ve been in lockdown. We had a gas
leak. But we raised $4 million, which was the biggest private
funding campaign ever in our community,” she says. “I’m glad we did
it. We’re providing a quality of care and of environ-ment that is
far superior to anything else in our area. I wouldn’t go back and
change things, but I’m glad we have that first year behind us,”
says Cog-swell, whose agency recently celebrated its 35th
an-niversary. “When we started doing our initial facility
projections in 2006, it was a very different regu-latory
environment than today. GIP level-of-care monitoring was not on
anyone’s radar screen. The projections we did then are now useless,
and from the conversations I’ve had with other hospices, those
operating in the black at the time no longer are,” she says. The
plan was to build 14 inpatient beds for a patient census of 180,
which has since shrunk to 150 with a drop in average length of
stay, but not provide residential-level care. “A lot of days of
care that used to be billed at the GIP level couldn’t be justified
today,” Cog-swell says. “Before you put a patient on GIP, you’d
better be able to prove what you have done to try to manage them at
home. That has not been the hospice community’s interpretation in
the past. But that’s definitely our interpretation today, based on
what we hear from around the country.” Cogswell says her hospice
has not experi-enced large-scale GIP level-of-care denials, but she
has tried to revise agency practice based on indus-try norms and to
tighten up admissions processes. “We now have a full-time medical
director and we try to put all of our eligibility and level-of-care
de-terminations in one place (within the agency). We
also instituted a couple of quality reviews, one for patients
referred but not admitted, and the other looking at all patient
discharges and revocations,” she explains. “I spent a five-year
capital campaign telling people in the community that we’d only do
GIP and respite care. Now I have more beds filled with
res-idential-level patients. Within our first six months we
realized that if we didn’t put residential patients in those beds,
they would be empty.” The hospice charges a room-and-board rate of
$225 for patients on residential care, paid in advance for two-week
periods and refunded if not utilized. “We’ve tried it a bunch of
different ways. We tried to work flexibly with families, and I
drove our staff nuts by trying to be as accommodating as possible.
We finally said that’s enough. If you are at the poverty level,
we’ll help you find a facility in the community. I’d love to be
able to offer this service to everybody, but I can’t,” she says. “I
had a hospice
colleague coach me early on by saying: If you base it on
‘ability to pay,’ nobody has the ability to pay for residential
hospice care. But if you charge them up front, it’s just not an
issue for many families.” One exception is for patients who are
brought in on
This patient room shows the homelike atmosphere at the 14-bed
Hospice House opened by Hospice of the Panhandle, Kearneysville,
W.Va., a little more than a year ago.Photo courtesy of Hospice of
the Panhandle.
CONTINUED ON PAGE 8
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restaurant, and a more abbreviated menu for pa-tients, with
soups, milkshakes, mac and cheese, comfort food, although they can
order anything off the full menu. Dinner at Spoons is a little more
formal, with table cloths, wait staff and dishes like Filet Mignon,
halibut and salmon,” she explains. Spoons Bistro was recently
awarded a TripAdvisor Certificate of Excellence award for its
hospitality excellence, as voted by customers. “When family members
are visiting, they of-ten come down and eat in the café. We also
have a room called the family kitchen in the Hospice House, which
is stocked with fruit, pastries, soup and frozen meals, stocked by
our food service staff. Our café has a commercial kitchen and we
serve everything from there. We contract with a food ser-vice
management company to staff and manage our restaurant, and we pay
them a management fee,” Walter says. “We probably could have
figured it out on our own, but it’s been nice to have someone who
really knows that business. We hit our stride recently with our
great executive chef and wonder-ful general manager, who are
included in our ad-ministrative team meetings.” Commercial-grade
kitchens cost more, she adds. “Construction is more expensive, and
state code requirements, such as a hood over the stove, add to the
costs. But we want to be accessible to our community. We want
family members to feel part of our community and come back to visit
us. We have a great patio and local musicians perform there. We
don’t have a liquor license but we have an agreement with a local
winery to be a ‘remote tasting room’ for them. Patients can also
order a glass of wine with their meals.” For more information,
contact Tom Mullinax at: [email protected]; Leslie
Griffith at: [email protected]; Sharon Lutz at:
[email protected]; and Terri Walter at:
[email protected].
COVER STORY, CONT. FROM PAGE 5
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www.hospicehouse.us August, 2015 8
GIP-level care while actively dying, and then their condition
stabilizes such that they’re no longer eli-gible for GIP but are
still actively dying. “Then the patient can stay and we’ll send the
family a bill.” Two other challenges Cogswell faced in the first
year of operation are the facility manager’s role and staff
scheduling. “I’m on my third inpatient di-rector. We never did this
before and we all had a lot to learn. The issues were more
administrative than clinical, although the inpatient director also
has to be available as emergency nurse to provide back-up on the
floor. Initially I had the inpatient director reporting to me; now
they report to our agency’s clinical director. This job is so much
about patient care and the things that happen to patients, wheth-er
at home or at the IPU. I am a nurse, but I’ve been in my
administrative job for 28 years. My clinical skill set just isn’t
there anymore,” Cogswell says. “We also made a decision to schedule
12-hour shifts for our Hospice House nurses and aides. There’s good
and bad to that approach. Staff like the three-day weeks, and you
end up with lower FTEs. But because we’re new and growing, we often
rely on home care staff to help fill holes in sched-uling the unit,
and they are on eight-hour days—so the schedules don’t match. We’ve
had many con-versations about this,” Cogswell says. “Call-offs when
census goes down can be nightmares. I’d love to have part-time pool
staff who could come in at short notice, but the reality is, in
this area, I can’t recruit for that.” The 14 beds are rarely all
filled, Cogswell says. More often the facility is staffed for
seven, and the agency brings in additional staff when cen-sus goes
above seven. “I think we need to do a bet-ter job of outreach to
referral sources—and to our own staff. Nobody in this community has
much ex-perience yet with hospice GIP-level care or how to use it.”
For more information, contact Cogswell at:
[email protected].
HOSPICE OF THE PANHANDLE,CONT. FROM PAGE 7
mailto:tommullinax%40hospicedesign.org?subject=
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Social Model Hospices: The “social hospice” model has been
highlighted recently with a Huffington Post blog posting by author
and hospice physi-cian Karen Wyatt, MD, and an article in the Tulsa
World about Clarehouse, dubbed the “moth-ership” of social hospice
homes. Dr. Wyatt said the social hos-pice, which is staffed and
oper-ated largely by volunteers, grew out of the AIDS hospice
resi-dences of the 1980s and now is needed again to “revolutionize
end-of-life care” in order to ad-dress looming national shortag-es
of family or paid caregivers for patients at the end of life. In
Tulsa, Clarehouse, founded in 2003 by Kelley Scott in a rented
three-bedroom apartment, has become a model for social hospices
nationwide. In 2009, a new 10-bedroom fa-cility was built
debt-free, with an outdoor chapel, offices, kitchen and den. Its
annual bud-get of $1.1 million covers staff and other expenses, but
guests are not charged to stay there. Another social hospice is now
being built in Tulsa by Cath-olic Charities, and 75 people gathered
in Tulsa in July for the third annual conference of the national
Social Hospice Net-work. The Inn Between is a project designed to
offer a Hos-pice House setting for terminal-ly ill, homeless
residents of Salt
Lake City, Utah. Organizers held an emotional ribbon-cut-ting
ceremony in May, then ran into the barrier of an emergen-cy
temporary ordinance passed by the City Council to block its
opening. It now appears to be moving forward as an unli-censed
congregate living facility of up to 16 beds for residents who can
exit the facility unas-sisted in case of a fire. The first
volunteer Hospice House of its kind in Utah, it will be housed in a
former convent and will also offer classes to clients and the
public. Admission criteria include a terminal diagnosis or serious
injury or illness that would qualify for home health care, and a
referral by a health professional. According to its website, about
50 homeless res-idents of Salt Lake City die on the street every
year.
Seven Cornell University stu-dents of various fields of-fered
advice in April to Dale Johnson, Executive Director of HHN-member
Hospicare & Palliative Care Services of Tompkins County,
Ithaca, N.Y., and HOLT Architects, who are planning a new wing for
the agency’s Nina K. Miller Hos-picare Center. In a seminar led by
Paul Eschelman, professor of design and environmental health
analysis at Cornell, stu-
Hospice House News & Notes From All Overdents presented
their ideas for how to maximize the comfort and psychosocial
support of hospice patients, with a focus on the patient’s
experience. Examples include using re-motes for adjusting the
cur-tains without having to get out of bed, offering bath towels in
the patient’s favorite color, and adding light and views of na-ture
to the patient rooms. “Our recommendations are concrete, with
special configurations to show how rooms can be shaped to support
the notion of con-tinuous change throughout the process of dying,”
noted human biology student Michelle Cor-rea.
The Flutter a publication of the Hospice House Network |
www.hospicehouse.us August, 2015 9
Evenings at Spoons Bistro and Bakery (see page 5), the café that
serves patients of HopeWest’s Care Center as well as the public,
wine is poured and the food gets a little fancier. Photo courtesy
of HopeWest.
http://www.huffingtonpost.com/karen-m-wyatt-md/social-model-hospice_b_7641916.htmlhttp://www.tulsaworld.com/communities/bartlesville/clarehouse-in-tulsa-pioneers-social-hospice-care/article_1dd3f684-fdf9-5107-bee1-44601bfaabac.htmlhttp://www.theinnbetweenslc.orghttp://www.theinnbetweenslc.org
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Our aim for the Hospice House Network and for this publication
is that they will become indispensable resources for all hospices
that have, are considering, or dream of building a Hospice House,
as well as a forum for the exchange of information, tips and
lessons learned. Tell us what you are planning and visit our
website at http://hospicehouse.us for more information, additional
photographs and links to other Hospice House resources. And if you
have a new Hospice House, please send us a picture.
Call To The Field
Flutter is published by the Hospice House Network, founded by
Jay Mahoney of the Summit Business Group, LLC, of Rochester, N.Y.,
in 2012 and currently under the management of Editor and Publisher
Larry Beresford. For information about membership or content in the
newsletter, contact him at 510/263-9446 or
[email protected], or write to HHN at P.O. Box 2224,
Alameda, CA 94105.
© 2015 by Hospice House Network. All rights reserved. Members
are permitted to reproduce this newsletter for their internal use
only. Other than that encouraged exception, no part of this
publication may be reproduced, in any form or by any means, without
prior written consent from the publisher.
This newsletter strives to provide timely and accurate
information related to hospice care generally and to “Hospice
House” matters specifically. Items in the newsletter are brought to
our readers from a variety of sources, all of which are thought to
be accurate and reliable. Nevertheless, it is specifically
understood that the publication is not intended to provide legal or
other professional services, counsel or advice. Readers requiring
such services are encouraged to contact appropriate
professionals.
We are moving and expanding our photo department to a publicly
accessible page at www.hospicehouse.us, and any HHN members that
want their own page with up to six photographs, captions and a
brief description of the facility and its features are welcome to
participate. Members may begin by downloading this form and
following the instructions on the form. Contact publisherLarry
Beresford at 510/263-9201 with any questions.
Would you like to feature your Hospice Housein the HHN Photo
Gallery?
The Flutter a publication of the Hospice House Network |
www.hospicehouse.us August, 2015 10
Question of the Hour:
What do you feel you have truly mastered from among all of the
tasks involved in operating a Hospice House facility?
If you will share your answer with your peers, along with a
sentence or two elab-orating on how you do it or what you have
learned, we will share the answers in an upcoming issue of this
newsletter.
The 14-bed Hospice House at Hospice of the Panhandle,
Kearneysville, W.Va., (see page 7) was planned to provide mostly
inpatient care, but in practice has also admitted residential
patients.Photo courtesy of Hospice of the Panhandle.
http://hospicehouse.ushttp://hospicehouse.us/about/photogallery.htmhttp://hospicehouse.us/about/photogallery.htmhttps://drive.google.com/file/d/0B60HzOxhUzSaZUZ3LXhkd1huN3c/view?usp=sharing