To the Editor:
As a former volunteer social worker for Heart of the Mountains Hospice (HMH) and operator of its Facebook page, I received many inquiries regarding the recent media coverage due to HMH “closing its doors” suddenly and canceling Hospice services this past week. Some of the inquiries were from concerned professional medical health care providers, some were angry and accused HMH of violating patients’ rights and patient abandonment by giving terminally-ill patients and their families only six hours notice of suspension of hospice services and some were mad at the County Commissioners and thought they were HMH’s governing body legally responsible for financial oversight and professional management. Many were sad hospice services would no longer be available here because they have received these services in the past for their loved ones and want hospice care for themselves in Grand County when the time comes.
According to the Code of Federal Regulation, Title 42-Public Health, Chapter IV-Centers for Medicare and Medicaid Services, Department of Health and Human Services, Part 418-Hospice Care, Subpart D-Conditions of Participation-Organizational Environment, 418.100 (b) states the standard or Governing body (Board of Directors) and administrator (Executive Director) of Hospice assumes full legal authority and responsibility for the management of the Hospice, the provision of all Hospice services, its fiscal operations, and continuous quality assessment and performance improvement. A qualified administrator (Executive Director)appointed by and reporting to the Board, is responsible for the day to day operations of hospice. So, Heart of the Mountains Hospice Board of Directors and its ExecutiveDirector are not the Grand County Commissioners. According to Federal and State Regulations, you can’t legally just “suspend Hospice services” to certified Hospice patients and their families because the BOD and Executive Director of the Hospice didn’t realize they were running “low on funds” which resulted in a fiscal crisis.
When the organization,(HMH),accepted Medicare reimbursement (Federal Tax dollars),and HMH is regulated and licensed by Federal and State Government as a Medicare Cerified Hospice Provider, the BOD and Executive Director agreed under legal contract called the Conditions of Participation to be held fiscally, legally, and regulatory responsible for HMH to CMS and Colorado Dept.of Health and Human Services. This means the BOD and its Director MUST know the fiscal state of the organization they have agreed to be responsible for and they know and understand Federal and State Regulations regarding Hospice services-so running out of money at the last minute and cancelling and disrupting Hospice services and patient care NEVER happens.
According to CMS regulations, Hospice patients are still entitlted to receive hospice services and can contract with the state for those services if they happen to become unavailable due to “extraordinary circumstances” (like running out of money unexpectedly and stopping patient care suddenly). However, the BOD of HMH Hospice or the Executive Director must contact the state to notify them to intervene for continued hospice services way before a fiscal crisis occurs and long before a disruption in Hospice services could happen. Nobody did. Regulatory ignorance is no excuse for patient harm.
Hot Sulphur Springs
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