A Closer Look at San Diego Hospice, Part 2

Posted by Blog Contributor Shelley Sansbury, health care strategist and former hospice and home care executive

 

Here are the facts according to 2011 SDH Annual Report furnished to the state. (Please note these data exclude services provided to patients in the SDH Acute Care Center, the license for which is in suspense.) SDH admitted 3,759 patients to hospice care in 2011. Including patients already on service their unduplicated census for 2011 amounted to 4,665. A total of 3.157 deaths occurred (67.5%). 543 non death discharges were reported. including 51 for whom prognosis was extended. The report specifies that 4,505 patients were actively served, and this unduplicated census accounted for a total of 363,629 Total Patient Care Days, including 346,350 Days of Routine Home Care (95.2%) and 12,059 Days of Inpatient Care (3.5%).

 

One of the measures I believe is useful in an assessment of a hospice is resource consumption as expressed in visits per patient-day

 

Discipline	Visits	Costs	Cost per Visit	Visits per Patient	Visits per Routine Home Care Day
RN & LVN	77,017	$17,743,679	$230.39	17.1	0.22
Social Services	22,435	$3,520,629	$156.93	5.0	0.06
Hospice Physician Services	23,930	$3,808,858	$159.17	5.3	0.06
Homemaker and Home Health Aide	60,020	$1.286,740	$21.44	13.3	0.17
Chaplain	16,968	$1,951,767	$115.03	3.8	0.05
Other*	0
Total	200,370			44.5	0.58

 

 

A review of the financial data for SDH represents what one might expect of an eleemosynary organization, with a service mission. That is, an operating loss subsidized by non-operating income, including memorials, donations, gifts and grants. Although the 28.2 % administrative cost burden seems possibly excessive,  nothing in this report suggests anything other than the performance associated with an industry leader.

 

 

REVENUE
Medicare	$104,918,252	83.3%
Medi-Cal	$12,022,848	9.6%
Other 3rd Party	$7,274936	5.8%
Private Pay	$1,413,167	1.1%
Other	$337,818	0.2%
Total Gross Patient Revenue	$125,898.449
Total Write-offs & Adjustments	<$54,722,163>
Net Patient Revenue	$71,176,286
EXPENSE
Visiting Services	$30,150,474	37.2%
Admin & General	$22.810,068	28.2%
Inpatient General Care	$8,915,012	11.0%
Hospice Service Cost Centers	$11,221,369	13.9%
Other Costs	$5,059,371
Total Operating Expenses	$80,980,525
Net Operating Margin	<$9,804,239>
Non-Operating Revenue including Memorials, Contributions, grants, etc.	$12,471,646
NET INCOME	$2,667,407

 I invite your comments. Anything extraordinary I'm missing?