A Colorado Department of Public Health and Environment investigation into Heart of the Mountains Hospice has faulted the organization for not adequately notifying and failing to find continued care for two patients after its abrupt closure due to financial problems last month.

A 19-page report from the investigation, which included interviews with hospice staff, leadership, patients and patient family members, accuses the organization of patient neglect and abandonment.

CDPHE opened its investigation into Heart of the Mountains Hospice on Jan. 6 after it received an anonymous complaint accusing the organization of abandoning two patients when it closed on Monday, Jan. 4.

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“The allegation that the hospice had neglected patients by failing to provide continued hospice care and services was substantiated,” the report states. “Based on this, serious and immediate risk to patient health, safety and welfare was determined.”

The report listed four organizational “deficiencies” in which the organization violated CDPHE’s standards, the first being that the hospice’s governing body, which includes a five-member board and an executive director, did not meet its standard of responsibility by shuttering the organization “without securing continued hospice services for existing patients,” a move CDPHE contends led to patient neglect.

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Secondly, the report states the hospice did not meet administrative standards by closing without notifying employees and patients and without arranging the transfer of patients, which “caused mismanagement of their medical conditions and created patient and family distress, hardship and anguish.”

Hospice organizations are required to provide bereavement services to family members for up to one year after a patient’s death, another standard the report contends the hospice did not meet.

The organization’s bereavement coordinator estimated there were around 25 families in the hospice’s bereavement program at the time of its closure, according to the report.

The last deficiency in the report asserts the hospice did not properly notify CDPHE of its intent to cease operations.

Former Board President Debbe Knutson, returning a phone call to another board member, told the Sky-Hi News she was unaware of the report.

The Sky-Hi News sent Knutson a copy of the report on Thursday, Feb. 11. In an email sent Tuesday morning, Feb. 16, Knutson wrote that the hospice’s attorney had just received a copy of the report and that the organization could not comment on the report until after conferring with its attorney.

A CDPHE official told the Sky-Hi News that the department had sent a copy of the report to Heart of the Mountains Hospice on Jan. 27.

Officials: Financial woes precipitated abrupt closure

Heart of the Mountains Hospice, which had provided palliative care to terminally ill patients in Grand County since 2001, informed patients and staff on Jan. 4 that it would close permanently that day.

At the time, Executive Director Mikee Tennant told the Sky-Hi News that she’d only been made aware of the imminent closure on Friday, Jan. 1.

Previously, Tennant said the organization had been having financial problems for months and hadn’t been able to raise enough money to continue operating through 2016.

Fundraising makes up 60 to 65 percent of the organizations budget while Medicare and private insurance reimbursements make up 35 to 40 percent.

Medicare gave the organization $152 per eligible patient each day, but a drop in revenue from fundraising, grants and donations coupled with rising healthcare costs and a long list of mandates put the organization in the red, Tennant said.

A similar account is given in the CDPHE report, with a board member telling interviewers that the hospice had experienced financial trouble for “a few years” as public funding, insurance reimbursements and fundraising efforts brought in less money.

An unnamed board member said they “aware of the possibility of a closure about 18 months prior,” when the former executive director left the organization, the report states.

Nurses association takes over patient care

During the investigation, hospice officials told CDPHE that Tennant had approached the Grand County Home Health Department about providing continuing services to patients.

The department, which declined to assist the hospice, announced that week that it would close its doors in February.

The hospice governing body didn’t make any other efforts at the time to secure continued services for patients, the report states.

However, Tennant told the Sky-Hi News in a previous interview that arrangements were made for the two remaining patients.

A February press release from the Northwest Colorado Visiting Nurse Association said the agency has been providing services to Heart of the Mountains Hospice patients since the agency closed in January.