The recent merger of two mainland hospice organizations has left hospice services on Martha’s Vineyard in a state of change as well.
In December Cape Cod Healthcare announced it would take over Rhode Island-based HopeHealth. Cape Cod Healthcare has already had a presence on the Vineyard through its Visiting Nurse Association, and will now take over for Hope Health Hospice, which had been the Island Medicare hospice provider for about 10 years.
The merger took effect on Feb. 1.
The change means starting from scratch for the new provider to form a working partnership with Hospice of Martha’s Vineyard, the long-running nonprofit that provides end-of-life care at no charge. Hospice of Martha’s Vineyard operates independently from Medicare and other insurance providers. In recent years it has worked in tandem with HopeHealth Hospice to meet the varying needs of Island patients.
Tom Hallahan, executive director of Hospice of Martha’s Vineyard, said he had worked closely with HopeHealth to form a memorandum of understanding and to educate the public about the collaboration.
“We started training volunteers together. We started doing public health fairs together. We really wanted to show collaboration, but most importantly to be able to educate consumers and families about what the differences are, how we could work together and that we were collaborators,” he said. “We wanted people to approach both of us simultaneously.”
Anne-Marie Peckham, president of the Cape Cod Healthcare VNA, the new administrator for Medicare-reimbursed hospice care on the Vineyard said she is optimistic about forming a new partnership.
“We’re nothing but hopeful and positive about this transition,” she said.
At the end of January, the HopeHealth hospice census was six patients, Ms. Peckham said. All have since been moved to the care of Cape Cod VNA. Cape Cod Healthcare is also in the process of taking over HopeHealth services on the Cape, including the inpatient McCarthy Care Center in Sandwich.
Ms. Peckham said her main focus at the moment is finding a full-time hospice nurse who lives on the Island. Previously under HopeHealth, a nurse commuted to the Vineyard from Rhode Island daily, with support from two part-time Island-based nurses for services after hours. In the interim, Ms. Peckham said the part-time nurses have worked a fuller schedule to care for patients while a full-time nurse is found.
“They became VNA employees and they’re managing the caseload,” Ms. Peckham said. She added, “It’s a temporary arrangement because both of them want to go back to part time, and we would be happy to have them at that level.”
She said she is in the process of interviewing an Island candidate for the full-time post.
“The problem with commuters is it’s very challenging to meet regulatory mandates when you’re using commuters,” Ms. Peckham added. “You have to provide 24 hour coverage 365 days a year.”
Founded in the 1960s and federally funded in the United States in the 1980s, hospice provides palliative care for patients with a terminal diagnosis and counseling for families. Most hospice patients on the Island are served by Hospice of Martha’s Vineyard, founded in 1981. But for those who for various reasons choose or need to use insurance, a Medicare hospice is a necessary presence on the Island. HopeHealth held that role for almost a decade.
Mr. Hallahan said there are situations where enrolling in a Medicare hospice makes more sense for all involved — including insurance reimbursement for hospital stays.
“That’s something that, as non-Medicare hospice, we can’t tap into,” he said. “So HopeHealth would then admit that patient, and sometimes it was the last 12 to 24 hours of the patient’s life.”
And sometimes it could go the other way, he said. A patient would need to discontinue Medicare hospice to pursue treatment, and transition to Hospice of Martha’s Vineyard while they did so.
“Sometimes people would want to explore some type of treatment that was perceived as life sustaining. Hope[Health] would discharge them, and they would come to us to explore that,” Mr. Hallahan said. He said coordination between two staffs along with volunteers and spiritual support allowed for a smooth transition for patients and their families.
Mr. Hallahan said the Hospice of Martha’s Vineyard census has grown significantly in recent years, and is now more than 30 patients, a change he attributes to the Island’s aging population. Last week, the organization reached an all-time high of 36 patients at one time, according to the clinical director.
Mr. Hallahan plans to add more staff in the coming year and hopes to move into a bigger space. The office is currently located in a condominium in the Tisbury Marketplace.
He said he too is optimistic about forming a new partnership with the VNA and had already met once with leaders on the Cape.
“We hope the VNA is successful, because if they’re successful, we are,” Mr. Hallahan said.
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