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St. Francis looks to fill hospice care void: Hospital plans 16-bed facility for south campus

September 25, 2006

St. Francis Hospital and Health Centers wants to raise $15 million to add an inpatient hospice to its growing campus on the south side of Indianapolis.

The free-standing hospice could house as many as 32 beds for terminally ill patients. Even though most hospice patients receive care in their own homes, hospital officials see the project as a chance to fill a market need and reinforce their system's Franciscan values.

"People get caught up, I think, in the definition of what a hospice is," said Dr. Gerald Walthall, St. Francis medical director for palliative services. "Hospice is not about being dead. Hospice is about living as fully and richly as you can until you die."

St. Vincent Indianapolis Hospital is the only other hospital that operates a freestanding inpatient hospice in the city, though Community Health Network is looking into building one.

Such facilities provide patients and their family with a level of attention and comfort that can be hard to find when hospice services are part of a regular hospital, care givers say.

But they also can add financial pressure because reimbursement for hospice care generally falls short of cost.

St. Francis is hoping to raise much of the money it needs by selling naming rights for the facility for $5 million to $7 million. It will sell naming rights for rooms, too.

The hospital network plans to build its hospice on eight acres in a wooded area on the south edge of its campus, which borders Interstate 65 on the Marion-Johnson county line. That location has seen steady patient growth since it opened in 1995. Recent projects include a Cardiac Vascular Care Center that opened last year.

St. Francis hasn't set a timetable for the next round of construction. It needs to raise the money before it starts building, and the fund-raising effort could take up to three years, said Mark Pflum, president of the St. Francis Healthcare Foundation.

The foundation is starting a campaign to raise $11 million for construction of the16-bed hospice. It's seeking another $4 million to cover any operating losses and the potential expansion to 32 beds.

The hospice will treat patients who have about six months to live and decide to stop forms of treatment aimed at curing them. The new building will emphasize comfort.

Patient rooms will resemble those found in a nice hotel. The hospice also will include dining rooms, family gathering rooms and a chapel.

The intent, according to Walthall, is to give patients "as much of a home-like environment as you can."

About 80 percent of hospice care takes place in either a patient's home or a nursing home, according to the Alexandria, Va.-based National Hospice and Palliative Care Organization.

While patients prefer home care, that's not always possible. They might need advanced care that's tough to deliver in that setting. Or their home might not have a room big enough for medical equipment and visiting family members. Inpatient hospice care also can provide exhausted care givers a break, Walthall said.

When a person needs inpatient hospice care, a hospital is often a poor alternative because its systems and general mind-set are geared toward "aggressively treating the disease," said Todd Stallings, executive director of the Indiana Association for Home and Hospice Care.

Medicare provides most of the reimbursement for this specialty, and that pay generally falls slightly below the cost to deliver care. Hospice representatives say it's difficult to estimate an average cost, but Medicare pays about $132 a day for home care and $587 for an inpatient stay.

Donations generally cover the difference, said Katie Wehri, director of hospice for St. Vincent Indianapolis Hospital, which also runs Indiana's lone children's hospice.

Medicare covers about 95 percent of St. Francis' hospice patients. However, good cost containment allows the system to cover its expenses with reimbursements, said Dawn Schultz, finance manager for St. Francis Home Health and Hospice.

Indiana has about 70 licensed hospices, with most focusing on home care, Stallings said. St. Francis and its Indianapolis counterparts Clarian Health Partners and Community Health also set aside hospital space for inpatient hospice care.

Even so, Stallings sees a dearth of inpatient care in the Indianapolis market. He said there's "always room for a good one.

"[St. Francis has] been doing a good job for a long time, so I have no doubt they'll have a great program when they get their facility built," he said.
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