Are We Ready for Hospice?

So, lately I have been discussing life changing decisions that have shaped my life. I find that it is usually good to let a little time go by before trying to really determine the blessings and knowledge that each decision has provided, however, I thought I would discuss the last three years at a high level at this time.


In order to really understand how it all came about, let's go back to 2003. In September of that year I was caught in a RIF and found myself out of work for the first time in approximately 15 years. It was pretty traumatic for me, but within about 3 months I was working for another company, considerably closer to home for almost as much as I had been making. The environment was shall we say, different. The language was outrageous, everyday it was a matter of trying to determine who was in a good mood, and who was not. The "bosses" seemed to be constantly shuffling for control, and for 2 years I dealt with not knowing if my job was safe or not. Then the layoffs started, and before they were done the business went bankrupt and I was again out of a job.


I had often thought about having my own business, and that longing became very strong as I started looking again for a decent position. The job market was (and frankly still is) very thin and after several months of looking there were no nibbles. My sister and I began discussing the idea of opening our own hospice. She had been working in hospice for many years as a visiting nurse, charge nurse, director of nursing, and several years in the office with exposure to many of the other facets of the business. I have a fairly extensive background in finance and administration. We began putting a business plan together, and it seemed more and more feasible that we could make a go of it.


I had about $180,000 in savings and investments including my retirement accounts. There were a couple of friends who were interested in investing with us, so all together we had about $210,000 and according to our business plan we should be okay. It would be tight, but we could not imagine it taking more than 15 months to receive Medicare/Medicaid certification (the majority of our patients would come from that community) and we had selected an area where there was not much competition with other hospices. The biggest obstacle was that my sister would need to plan on staying in Colorado for at least 2 and preferably 3 years. That was going to be hard as her children had all moved to Arizona to be with her and her husband.


The first concern was that her husband did not come up with her. He had a good job there and did not wish to change positions. She felt that it would be fine, as she would "travel" back and forth every couple of months. My assumption was that they had already worked out the issue of funding these trips. You remember about "assumption" don't you. Pretty soon she is working nights as a charge nurse in a nursing home and really missing her husband, children, and grand-children. At the end of four months we have our state license and we are ready to begin working toward our Medicare/Medicaid certification. Two months later, I am on a business trip to learn some software that will be used. While I am gone she makes the decision to close the business and go home. She called our patient families and told them to find a new hospice because we are closing our doors. She let the other nurses and the CNA go, and told the rest of the staff we were closing our doors. She packed her things and her husband picked her up and they were gone. I never had any input into what was planned or how things were handled.

I tried to salvage the business, hired a new RN and CNA, managed to fine new patients, talked the rest of the staff into waiting to see if we couldn't get Medicare/Medicaid certification. We finished out the year with no news. As the new year began, the surveyors came out to go through our files, talk with our client families, and make their final judgement. There were lots of things that they wanted clarification on, and we were able to get all but one objection resolved. The one area where they would not budge was that "we" had inappropriately and improperly transferred patients at the time of my sister's departure. We would have to wait at least another 15 months to receive our certification to bill Medicare/Medicaid. That being said, we really did have to close our doors. I was completely out of money, and with that much of a wait ahead of us, there was no loan to be had. However, this time we took care to properly transfer each patient to a new hospice and to coordinate the transfer of information. New grief counseling was arranged for each of our families. We also took the time to provide recommendations for each of the staff members and to help place them prior to closing our doors. Assets that could be sold were, and the resulting funds were placed toward amounts due for drugs, DME, and the answering service. Other creditors were notified appropriately and we closed the doors. So the answer to the question above is apparently NO.

I lost my home, my car, my savings, and my company. I also lost everything that others had invested in the company. We had to file bankruptcy. Mother and I moved from our beautiful 5 bedroom home to a 2 bedroom apartment. We had to sell or give away 75% of our furniture, most of which had significant family memories attached. It was an awful time for us. On top of that, I still did not have a job. It wasn't until September that I was able to start working again, and then at such a reduced wage that I am unable to even buy lunch out once a month. I can pay the rent and our utility bills, but not one thing extra. The court is still taking my income tax refunds.

There was a family in the ward with a car they were willing to donate to a good cause. The Bishop convinced them that I was such a cause, and now I have a method of getting to and from work. I drive 46 miles one way to and from work each day. Thankfully, it has a relatively small gas tank and gets good mileage. It takes $50 or better to fill the gas tank, and I have the distinct privilege of filling it two or three times a week. It takes a minimum of 75 minutes to drive to or from work. I have found that listening to tapes of old conferences talks, and other good books or devotional talks helps utilize the time better than listening to radio. I also realize that I do not have to shovel snow off of a double car driveway or sidewalks that stretch forever. However, the complex maintenance men do not get our walks cleaned before I go to work, and usually they do not get them done before I get home either.

The "laundry room" is now in the kitchen so there are no stairs or long walks to put laundry away. There are no stairs as we live on the ground floor. There is no yard to mow, and no flower garden or vegetable garden to tend. I really miss the flowers, vegetables, grapevines, and beautiful trees. There is no grass by our unit as it is on the edge of the property and the maintenance men are not into fighting off the encroaching field. They have just let the weeds take over. It takes about 1 hour to clean the house each day, and that is if we have been messy which usually is not the case. We are "out of debt" but not via a very honorable way. I feel like I have let too many people down, but I don't know what I could have done differently other than to not have taken the chance. It was a wonderful cause and a noble effort.

I have to get over the anger I feel toward my sister. I have to forgive her, but I am having a problem with that. It would be easier if I thought she felt bad about the position that I was left with; but she doesn't. She is of the mind that she did things right. She left us open to multiple liability suits and other court action. She still does not get it. She could have gone home, but she needed to do it properly. She needed to talk to me about it and wait until I had a new RN. Better yet, she always could have said, "I cannot leave my family that long". Six months is not enough time to start a business. Think about it!