BECKLEY, W.Va. — Hospice of Southern West Virginia (HSWV), which serves terminally ill patients in Raleigh,
Summers, Fayette and Wyoming counties is urging legislators to pass a bill that would freeze current hospice standards and
create a review work group.
HSWV, as well as many other hospices in the state, are concerned about the proposed change to the Certificate of Need
formula. Raising the percentage of deaths a hospice must serve in a county from 25% to 49% could hurt many West Virginia
hospices, especially those in rural areas. The Governor’s intent with this change may be to ensure more terminally-ill patients
in West Virginia are offered hospice care, but 49% of all deaths would be higher than the national average of Medicare
HB 2825 and SB 537, which are currently identical bills in the committee process, would freeze the standards and create a
work group to review the criteria and make recommendations based on accurate data and projected need for hospice services.
Our goal is to have standards that meet the needs of terminally ill patients in our state.
Good data is not available at this time to determine if there is an unmet need. Many things have changed since 2015 and to
ensure access to quality hospice care, we need stakeholders to meet to make decisions on the right need methodology rather
than basing it on old, inaccurate data. Moreover, ALL DEATHS include inmates, veterans, patients served at Federally
Qualified Health Centers and Rural Health Clinics all of which have barriers to accessing community hospice services.
Some large for-profit providers are known to concentrate on margins over mission. This model is unlike non-profit hospices
where every dollar earned is invested back in the organization in capital, employee wages and charity care. Because
reimbursement rates are fixed, profits are often made by reducing the quality of services. For example, a typical patient on
HSWV service receives two nursing visits a week. Some profit-focused hospices only provide the minimum number of
required visits which is one Registered Nurse visit every 14 days. These hospices are not interested in serving rural counties
like Wyoming and Summers. Their focus is on more urban areas like Raleigh County where travel times are reduced and
transportation costs are lower. At HSWV, any excess revenues earned in Raleigh County are offset by the care provided in
our more rural and less populated counties.
The four-county communities HSWV serves has profoundly invested into our mission. The HSWV infrastructure, including
the Bowers Hospice House and the Nancy Wickham Administrative Building, is a direct result of the generosity from our
community. It has only been through community donations, grants, fundraisers and memorial gifts that has allowed our
hospice to build this infrastructure and grow. A change in the certificate of need formula threatens our organization, and in
turn, threatens the investment of communities we serve.
Once the CON is out of our reach, our small organization with more than 150 employees will suffer, as will West Virginians
in rural counties that will be heavily impacted. We are asking legislators to pass HB 2825 and SB 537 to allow a work group
the opportunity to review the hospice standards and make recommendations based on accurate data and projected need for
hospice services. We want to continue our mission-driven philosophy of providing “A Special Kind of Caring” to our
patients and their families for many years to come.