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Greensboro Hospice works to cope with growth

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Todd Cohen

GREENSBORO, N.C. — Last year, in the face of fierce demand for skilled nurses in a highly competitive market with a chronic nursing shortage, turnover among the 68-member nursing staff at Hospice and Palliative Care of Greensboro totaled roughly 40 percent.

To address its need for nurses, Hospice has been preparing for a campaign that will kick off publicly next year and aims to raise $4 million for an endowment that would generate roughly $180,000 a year in income to support competitive salaries and additional education for nurses.

“Hospice is competing against hospitals and other entities that often can offer high salaries for nurses,” says Pat Soenksen, president and CEO.

Addressing its need for nurses is one of several challenges for Hospice because of rising demand for services, growing uncertainty about the economy and projected cuts in Medicare reimbursements.

Founded in 1980 and operating with 200 employees, 200 active volunteers and an annual budget of $17 million, Hospice cared for 1,230 patients in the fiscal year ended Sept. 30, 2007, up 7 percent from the previous year.

Driving the growth in demand have been the aging of the population, with nearly 80 percent of Hospice patients now over age 65, as well as growing awareness about Hospice, easier access to information through its website, and increasing evidence that hospice care can save money, Soenksen says.

A 2007 study by researchers at Duke University, for example, found that hospice care reduced Medicare program expenditures during the last year of life by an average of $2,309 per hospice user, she says.

But with costs rising and Medicare reimbursements covering 92 percent of patients Hospice serves through its home-care services, she says, projected Medicare cuts could have a “very deleterious effect.”

With reimbursements from Medicare, Medicaid and private insurance covering all but $1 million of its annual budget, Hospice counts on charitable donations to address services it offers for free and for which it is not reimbursed.

United Way of Greater Greensboro, for example, gave Hospice $350,000 last year to support its Kids Path services and its counseling and education center.

Kids Path, which serves medically fragile and dying children and those who are grieving, is “financially vulnerable” because Hospice does not receive the reimbursement for it that it gets for other programs, Soenksen says.

Paul Russ, director of resource development at Hospice, says the program fills an important gap.

Not only does Greensboro lack a children’s hospital, he says, but the U.S. health-care system is geared to use aggressive measures to keep children alive, not to ease their suffering or make their dying easier.

So children who are seriously ill or dying “end up falling through the cracks,” he says. “Our strategy is to ensure that we can continue to offer this program to the community that they need and for which there are not good reimbursement sources.”

In April, Hospice held its first “Corks for Kids Path” wine-tasting event, attracting over 400 guests, most of them young professionals the group was targeting, and netting over $37,000.

Hospice is recruiting volunteer leaders for its campaign for a nursing endowment, which will be named for Eloise Lewis, a founding Hospice board member and former nursing dean at UNC-Greensboro who made one of the first planned gifts ever to Hospice, a gift that will serve as the seed for the endowment.

Hospice, which operates Beacon Place, a 14-bed in-patient facility, also looks for ways to address the needs of underserved populations, Russ says.

Based on an outreach effort by Hospice three years ago in African-American churches to raise awareness about hospice care, African Americans last year represented just over 20 percent of its patients, compared to just over 15 percent of hospice patients throughout North Carolina and just over 8 percent throughout the U.S.

Hospice currently is seeking grant support for a marketing program to raise awareness about hospice care for eligible cardiac patients.

Last year, Hospice completed a campaign to build its endowment and raise awareness about planned giving, or gifts that are deferred or complex or involve assets other than cash such as stock or real estate.

The campaign increased Hospice’s endowment to $10 million from $3 million and generated $600,000 in planned gifts.

And as it prepares for its holiday “Light Up a Life” memorial service and fundraising effort, Hospice also is bracing for the impact both of rising gas prices on its staff and volunteers who visit patients in their homes, and also of projected Medicare cuts on the services it provides.

“Costs are rising but Medicare reimbursement is steady but declining,” says Soenksen. “So we have to be creative.”

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