Choosing a Hospice? For-Profit and Non-Profit Options

There Are Two Basic Types of Hospice: Privately Owned and Non-Profit

There are two basic kinds of hospice agencies: for-profit and non-profit. For-profit hospice agencies tend to be large and may be owned by larger corporations. For example, Vitas Hospice is the nation’s largest hospice provider and is owned by Chemed who also owns Roto-Rooter. Another large for-profit agency, Heartland is owned by HCR Manor Care. The owners of these large, for-profit hospice agencies are the stockholders who invest in them and their aim is to remain financially solvent. In contrast, a non-profit hospice agency isn’t out to make anyone a profit. Of course they are also concerned with the financial well-being of the agency but their focus is typically to serve the community that supports them.

I have to be careful to point out here that non-profit agencies aren’t always better than for-profit. There are some really bad non-profit agencies and some really good for-profit. You shouldn’t let ownership of an agency be your only deciding factor.

Another word of advice for patients in nursing homes: Be wary of hospice agencies that are owned by the nursing home or “comfort care” programs offered by the nursing home in place of hospice care. Hospice workers who come into the nursing home are an extra set of eyes and ears and are focused only the well-being of their patients. They will be more likely to report any deficiencies in care to you and to the nursing home staff if they aren’t owned by the same company.

Also be weary if the nursing home tells you they only work with one hospice agency. Sometimes hospice agencies woo nursing homes with incentives and goodies to encourage them to refer business. Having worked for a for-profit agency in the past, I saw this type of schmoozing first hand. They may agree to admit patients to hospice on a higher level of care that pays the nursing home more money or provide the directors and staff meals, gifts, etc., to win over them over. This can lead nursing homes to steer their residents and their families toward the hospice agency that they prefer, not necessarily the hospice agency that the family wants or the one that provides the best care.

This isn’t to say you should never use a hospice agency your nursing home recommends. Because they see firsthand the kind of care hospice patients are getting, they are the best ones to recommend a good agency. If, however, your nursing home tells you they only work with one particular agency and that they won’t allow another one in the facility, that’s a red flag that there could be some shady practices happening. It may lead you to think twice about the nursing home your loved one resides in.

Bottom Line: While it's important to know who owns the hospice, don't assume for-profit is any better or worse that non-profit. You might feel like a "for-profit" hospice would be more concerned about the bottom line, but actually, at the end of the day, personal recommendations and your own feeling visiting the hospice are the most important things to consider.

Next Question: Which Pharmacies Work with the Hospice Agency?

(To see all the considerations that are important when choosing a hospice, please read this article Tips for Choosing a Hospice)