Bridging the Gaps

Updated on October 15, 2013

Sep13_FinalRule_ivanko headshot copyBy Barbara Ivanko

Betty’s room is on the east side of the building. Betty cherished the early daylight pouring through her window, remembering her first morning here at the long term care facility, eight years ago. The morning sun through her window that long-ago day assured her that this was meant to be her home.

As a morning person, most days Betty would rise with the sun. When the weather was nice, she ventured outside, crossed the small bridge that spanned the courtyard pond, and enjoy the morning rays in the patio that she had come to frequent.

The past several months have not been quite as bright for Betty. Diagnosed at the beginning the year with congestive heart failure, she had begun lately to take in the sunrise from her room. As her mobility declined, Betty talked with her children and engaged the services of Family Hospice and Palliative Care. Her quality of life has been the number one priority of Betty’s family and her hospice care team. Morning sunrises are still on the to-do list.

Betty’s decision to contact Family Hospice was an easy one, because she was so pleased with the care we provided to her husband several years ago. Now, thanks to a new regulation from the Centers for Medicare and Medicaid Services (CMS), that same decision should be just as easy for residents of any long term care community.

The new rules from CMS, which took effect August 26, govern how hospices and long term care facilities provide care for patients who choose hospice under the Hospice Medicare Benefit.  The benefit is an entitlement to all Medicare Part A beneficiaries. The purpose of the changes is to improve coordination of care between hospices and long term care facilities, resulting in better quality of life and delivery of services for patients who select hospice care. It also contains a provision that ensures that long term care facilities honor the patient’s right to choose hospice, and to receive care from the hospice of their choice. This is important because not every hospice is the same. Each has its own philosophy of care and range of services. Family Hospice offers expressive art and music, massage, and other services beyond the minimum requirements of Medicare.

Family Hospice embraces the new rule, as it assures more consistent communication among the long term care facility, patient, and the hospice chosen by the patient. CMS realized that nationwide, hospices and long term care facilities were not always on the same page. In some cases there was duplication of services – and in others, gaps in service and care.

As experts in end-of-life care, Family Hospice works with long term care providers to determine the best plan of care for those facing a life-limiting illness. In fact, Family Hospice recently offered free webinars on this topic to local nursing facilities with the intent to make the rule clear and ensure ease of implementation.

Family Hospice cherishes opportunities to serve families and help patients make the most of every day. Our hospice care teams work with patients and caregivers to develop the right plan of care for each individual.  We want as many people as possible to have the chance to cross that bridge and enjoy the sunrise.

To change gears a bit, I am thrilled to become a member of Pittsburgh’s health care community and look forward to sharing my experiences from Family Hospice with you every month.  I gained my hospice experience in Florida – and that is where I developed my passion for end-of-life care. Western Pennsylvania’s reputation for innovative health care is well-known, and I look forward to meeting and getting to know so many of you that make a difference in so many lives.

In the meantime, I’m happy to share with you that I am already falling in love with Pittsburgh. The hints of Autumn weather; the sidewalks that invite us to walk and meet our neighbors; and the friendly people I continue to meet are just some of the things that I’m already enjoying.

I look forward to sharing these and many more things with you.

Barbara Ivanko is President and CEO of Family Hospice and Palliative Care. She has more than 20 years experience in the health care and hospice and is an active member of the National Hospice and Palliative Care Organization. She may be reached at [email protected] or (412) 572-8800. Family Hospice and Palliative Care is a non-profit organization serving nine counties in Western Pennsylvania. More information at and

Throughout the year, our writers feature fresh, in-depth, and relevant information for our audience of 40,000+ healthcare leaders and professionals. As a healthcare business publication, we cover and cherish our relationship with the entire health care industry including administrators, nurses, physicians, physical therapists, pharmacists, and more. We cover a broad spectrum from hospitals to medical offices to outpatient services to eye surgery centers to university settings. We focus on rehabilitation, nursing homes, home care, hospice as well as men’s health, women’s heath, and pediatrics.