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SECTION 1: Synopsis of Operations

2. HOW LONG DO MOST PATIENTS RECEIVE CARE? a. The total number of days that a hospice patient receives care is referred to as the length of service (or length of stay). Length of service can be influenced by a number of factors including disease course, timing of referral, and access to care. b. In recent years the median length of service has declined slightly while the average length of stay has increased by 3.5 days. c. Denver data for 2013 is similar to the US in average length of service (69.9 in 2013) but has a longer median length of service (36.3 in 2013). d. The length of stay is important since Medicare reimburses hospice care by the day. Over a third of the patients stay less than 7 days, while a significant percentage stay in excess of 180 days. 3. WHERE DO HOSPICE PATIENTS RECEIVE CARE? a. The majority of patient care is provided in the place the patient calls “home” (Table 1). In addition to private residences, this includes nursing homes and residential facilities. The percentage of hospice patients receiving care in a hospice inpatient facility is decreasing.

Table 1. Location of Hospice Patients at Death Location of Death 2013

2012

Patient’s Place of Residence

66.6% 41.7% 17.9%

66.0% 41.5% 17.2%

Private Residence

Nursing Home

Residential Facility

7.0%

7.3% 7.4% 6.6%

Hospice Inpatient Facility

26.4%

Acute Care Hospital

7.0%

b. Hospice in the Nursing Home . As the average life span in the United States has increased, so has the number of individuals who die of chronic progressive diseases that require longer and more sustained care. An increasing number of these individuals reside in nursing homes prior to their death. This increases the importance of Nursing Homes as the place where hospice care is received.

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