Hospice of the NW considers sale to a for-profit company

The hospice has been locally managed since 1989.

Owners of a locally managed hospice that has been serving Island County since 1989 are considering the sale of the entity to a national corporation, causing concern among staff and community members alike.

Hospice of the Northwest is currently a government entity and not-for-profit company owned by two public health districts, Skagit County Public Hospital Districts 1 and 304. It serves Island, San Juan, Skagit and Snohomish counties.

“Like a nonprofit, our profits can be retained internally or distributed to the public hospital districts, which spend it on the community,” said Bob Laws, the hospice’s executive director and public information officer.

The hospice has served 47 patients on Whidbey this year as of Sept. 30, according to Laws. There are five staff members, most of whom come from off-island, who primarily see Whidbey’s patients.

A year ago, Hospice of the Northwest received an unsolicited offer to consider a potential sale. Since then, there have been discussions between the hospital districts and Bristol Hospice, the national for-profit corporation looking to purchase the not-for-profit joint venture corporation.

At this point, discussions are still in the preliminary phase and no decisions have been made yet. Brian Ivie, the CEO of Skagit Regional Health, which Public Hospital District 1 operates, said information is still being shared and comparative data is being viewed.

“We are trying to determine if in fact the ownership of Hospice of the Northwest by a national organization focused on hospice would allow for continued improvement of an exceptional organization,” Ivie said.

When asked if the decision is a financial one, Ivie said thankfully it is not.

But staff and community members have expressed concern about the possible sale, worrying that local management of the hospice would be undermined.

An online petition has been created in support of keeping the hospice locally owned and operated. So far, it has 3,183 signatures.

The hospice’s workers have shared their worries that a for-profit corporation might not support patients of all ages, may not provide interdisciplinary services or focus on rural areas, such as Whidbey and San Juan Island.

For San Juan Island in particular, Hospice of the Northwest is the only one of its kind serving the patients who live there.

Hospice of the Northwest currently offers a broad selection of services beyond the typical nursing model of hospice care. In addition to nursing professionals and social workers, patients can receive music and massage therapy and speak with spiritual counselors.

“I really want this hospice to be the one I get,” said Sarah Roberts, who does social work on Whidbey for the hospice.

Roberts acknowledged that it’s not easy providing rural health care, especially when a drive down Whidbey from one end to the other can take as long as an hour, sometimes more.

She added that it can be easier for a company to increase services in Snohomish County, where there are already several other hospices operating, and lose focus on the other rural areas.

Halley Harris, who also does social work for Whidbey, said there are concerns that Bristol would outsource management, which would put local management at risk.

“The majority of the concern is really focused on the service provided to the community,” Harris said. “This is a really dedicated group of people.”

A third employee serving Whidbey, who wishes to remain anonymous, also worried about the quality of care suffering under the ownership of a national corporation. He said under the current management, workers have time to focus on a smaller number of cases, whereas a company looking to increase profit is also looking to increase the size of caseloads.

The CEO of Bristol, however, said concerns like these are unfounded.

“We are interested in providing services to all the islands that Hospice of the Northwest is currently serving,” Hyrum Kirton, Bristol’s CEO, said.

Kirton said the company feels there is a need for increasing some levels of care in Snohomish County, but it would not be at the expense of care currently being given in the other counties being served.

The average caseload of a Hospice of the Northwest worker is between one and 12 cases, and Kirton said the hospice’s employees would continue to have the same number.

“We have no intention of changing caseloads,” Kirton said.

Kirton said Hospice of the Northwest already has a great bereavement program, which would continue if the sale were to happen. He added that local management, such as the staff working in the hospice, would remain the same.

Bristol would, however, provide accounting and payroll, the functions of a business that are currently being provided by the hospital district.

Kirton pointed out that Bristol has two programs for dementia patients that Hospice of the Northwest currently doesn’t have.

He said Bristol also supports pediatric patients.

Under Bristol ownership, Kirton said the local leadership team will be able to gain access to the best practices of the 35 other hospices and connect with them.

Ivie also stressed that having access to these resources would be a strength for the staff members of Hospice of the Northwest.

Statistics for the number of days of bedside care indicate that Bristol averages 82 days, with the current average for Hospice of the Northwest being 60 days. Kirton said Bristol could bring that additional 22 days of service to patients.

“It’s been well proven that patients that receive more hospice care earlier have a better end-of-life experience,” he said.

Bristol accepts insurance, Medicare and Medicaid but does have an application process to ensure people aren’t “gaming the system,” Kirton said.

Hospice of the Northwest has a nonprofit foundation that supports it, which is not included in any sale of the hospice.

Wendy Coates, the foundation’s executive director and public information officer, said it will be able to continue providing “the extra touches,” such as music and massage therapy.

“The biggest barrier to those programs continuing is a lack of donor funding, it is not a change in agency ownership,” she said, adding that for 2020, the foundation is about 25 percent behind its goal in donations.

In 2019, the foundation gave $566,712 to Hospice of the Northwest.

Kirton said Bristol would support the foundation.

“We would provide transparent use of funds and continue to donate funds of our own to that foundation because we believe in its mission,” he said.

Coates said the foundation handles direct patient requests. Sometimes that can be helping with cremation costs, or assisting patients who need food or the bills paid.

In one instance, she gave the example of a young newlywed patient who needed a hospital bed but wanted to be able to fall asleep beside her husband at night.

The foundation was able to help pay for a larger, specialized bed for the couple.

“We’re here to help people,” Coates said. “We’re not here to help shareholders.”