Mountain Valley Hospice 2015 Annual Report

Mountain Valley Hospice 2015 Annual Report

Message from President/CEO: In 2015, Mountain Valley Hospice helped 318 patients and families reclaim the spirit of life. Mountain Valley Hospice helped them understand that even though death can lead to sadness, anger and pain, it can also lead to opportunities for reminiscence, laughter, reunion and hope. The Mountain Valley Hospice staff goal is to help those we serve to continue to hope and plan each day for optimal quality of life which always includes comfort, respect and dignity. Hospice is never about giving up hope but restoring it and helping people determine where they can continue to find hope. The hope that patients and families have has a different meaning to each patient and their loved ones. Our compassionate Mountain Valley Hospice team members focus on supporting the patient based on the individual s choices, so that they may live life as fully as possible for as long as possible. Care focuses on life with hope: hope to be pain free, hope to spend time with family, hope to attend a special family event, and a hope to live each day in comfort. Hospice comes from the linguistic root hospitality and has existed since medieval times. Hospice also means shelter, a home providing care for the sick, especially the terminally ill and a place where travelers can stay. The Nancy Dowd Hospice Home is designed for those who are traveling on the journey of life. In 2015, we served 81 patients and families who allowed our hospice home to be a place where life and hope intersect. Our Nancy Dowd Hospice Home is designed to provide 24/7 care and support for those who are unable to remain in their own homes. Mountain Valley Hospice promotes comfort, dignity, family time, and quality of life. Family can focus on each other, while our experienced hospice team members focus on your loved one s well- being and comfort. Family members can choose to participate in the care of their loved one, visit with patient, sit quietly, enjoy a meal with the patient or enjoy some time in our beautiful great room by the fireplace. Wherever or whatever the journey of life may bring to each of our patients, Mountain Valley Hospice is honored to be a part of that journey. For this, we thank you. Sincerely, Susan Frasier, RN, CHPN

Annual Report 2015 A Legacy of Caring: In 1983, a group of concerned Fulton County citizens met to begin exploring the hospice concepts for its citizens. In 1988, the community based, not-for-profit agency was founded. In 2003, a capital campaign began to raise funds for an eight bed residence so that patients who were unable to remain at home had a place to spend their final time. This Hospice Home would specialize in end of life care. In June 2005, the residence opened with great celebration and the first patient was cared for in August 2005. Mountain Valley Hospice continues to support patients and families in our community during one of life s most stressful-yet most meaningful times. As a life-limiting illness progresses, patients and families realize that every moment is precious. At Mountain Valley Hospice, we work with patients and families so that they may enjoy life to the fullest of their abilities, helping them create special times and memories together. We honor their wishes and encourage self-determined life closure. We provide support that they need to live each day with dignity. With more than 27 years of experience and expertise in caring for individuals and families in Fulton, Montgomery, Hamilton, and Saratoga counties, we provide an Interdisciplinary Team approach to care and services to help patients and families embrace living every moment. Because we are a mission driven, non-profit organization, we believe everyone deserves the right to pass with comfort and dignity. Our Mission Mountain Valley Hospice seeks to make hospice care available to all patients and families in the geographic service area regardless of race, creed, gender, or ability to pay. In providing care to persons with a limited life expectancy, hospice neither attempts to prolong life nor hasten death. The goal of hospice care is to alleviate symptoms- physical, emotional, spiritual, financial, and social-enabling the patient and family to concentrate on living. The focus on patient perceived needs allows control to remain with the patient. Mountain Valley Hospice provides care that is palliative, holistic and supportive. Our Vision We are committed to the provision of excellent care for the communities we serve. As an integral part of the healthcare system, hospice leads in the planning and provision of services at the end of life. The communities we serve are fully aware of the accessible, cost-effective, and compassionate care we provide.

Our Values Our vision is guided by the principles of responsive care, teamwork, leadership, and stewardship. Care to the patient and caregivers will enable those served to experience death with grace and dignity. The Board of Directors, staff, and volunteers work together to: Provide quality, compassionate hospice care; Educate the community about death and dying; Promote openness, trust, competence, and innovation; and Acquire and wisely manage resources. In 2015, we served 318 hospice patients and their families in their homes, in local nursing homes, adult homes, in-patient hospitals and the Nancy Dowd Hospice Home. Our beautiful Nancy Dowd Hospice Home provided a safe, homelike environment for those who could not stay at home or requested a room to have 24 hour/7 days a week care. In 2015, Mountain Valley Hospice provided unreimbursed and unfunded patient care, family services and programs, community and health professional education, and other valuable support. 2015 was a year filled with challenges including: Increase in OIG widespread probes- focus on GIP additional hospice oversight and hospice surveys every 36 months. Rethinking in terms of terminal prognosis. As hospice providers, we must reframe the way we think about and characterize our patients and the scope of our responsibility in providing care to them, shifting from submitting a single diagnosis on the claim form providing a more comprehensive and accurate picture that validates each patients eligibility for hospice care focusing on the basis of their terminal prognosis. CMS CR 9114- Attending physician must be identified on the hospice election statement. HQRP Data Submission and Compliance Thresholds for FY2018 Payment Determination and Subsequent years. Reporting on hospice claims all diagnosis whether related or unrelated to the terminal prognosis. 2016 Wage Index: Beginning on January 1, 2016 there will be a two tiered routine home care rate based on LOS (length of stay). Also, there will be a Service Intensity Add-on (SIA) added on for the last 7 days of a patient s life for RN and Social Worker visits up to four hours per day. Hospice Experience of Care Survey using a CMS approved third party vendor mandatory which will take affect FY2018 annual payment updates. ICD-10 Implementation. These changes along with continued decrease in reimbursement, while expecting hospice to absorb more of the patients medication and treatment expenses continue to make balancing our budget a challenge.

In October 2015, Andrew Reed, CPA, President/CEO of Multi-View Inc. provided a retreat for Mountain Valley Hospice Board of Directors and Leadership that addresses current issues, trends and brings to light the innovation of outlier and leading edge hospice programs. The goal of the program was to provide dialogue concerning how a hospice can position itself TODAY for what will be needed in the FUTURE based on quantified best practices. The program provided information on traditional hospice paradigms and provided an inspirational vision of the hospice of tomorrow. The Board of Directors made an important strategic decision to adopt The Model, a high-quality predictable experience for every patient, every time that is financially balanced. And per Andrew, If done well will be phenomenally profitable. The Board continued to support the move to expand the extent of quality of patient care by communicating with other regional healthcare providers to explore possibilities for collaborative services-primarily palliative care. Mountain Valley Hospice is actively involved with DSRIP (Delivery System Reform Incentive Payment Program) the NYS Medicaid Redesign Team reforms, Palliative Care Project (3.g.i) both with Adirondack Health Institute and Alliance for Better Healthcare. Policies and Procedures Administrative, Clinical and Human Resource Policies have been reviewed on a continuous basis and updated as required by changes in Medicare/Medicaid regulations. Quality Assessment and Performance Improvement Program (QAPI) Mountain Valley Hospice continues to maintain an effective, on-going, hospice-wide and data driven quality assessment and performance improvement program that reflects the complexity of the hospice s organization and services. The QAPI Committee includes representatives from all disciplines and Board of Director members who participate in the on-going performance improvement process which encompasses all aspects (clinical and non-clinical) of the hospice operations. Employees and Volunteers At the heart of Mountain Valley Hospice are staff and volunteers. We employ approximately 50 Full- Time, Part-Time, and Per-Diem staff members. Our volunteer workforce of nearly 50 contributed to over 2,178 hours of patient support and care annually. Total cost savings provided by volunteers exceed $27,225.00 (in kind). Bereavement Services Mountain Valley Hospice has an organized Bereavement program for the provision of bereavement services available to the hospice patient s family members, caregivers, and significant others and to the community at large. Helping families adjust to the loss of their loved one continues to be an important goal of Mountain Valley Hospice. Bereavement care was provided to 2,250 contacts during 2015 including memorial services, mailings, telephone contact, individual counseling, support groups and providing bereavement literature.

Community Education Mountain Valley Hospice provides education to community groups and referral sources with the goal of increasing awareness of and access to hospice care. In 2015 education/outreach was provided to: Senior Groups Primary care Physicians and their staff Specialty Physicians Churches and Church Organizations Adult Homes Nursing Homes Hospitals FMCC RN Students HFM BOCES LPN Students Strengths A dedicated, professional Interdisciplinary Team and Board of Directors who are committed to providing high quality end-of-life care and support to patients and their families. Mountain Valley Hospice served 318 patients and their families. The Team provides a collaborative approach, always thinking outside of the box so that each patient is able to obtain self-determined life closure. The Interdisciplinary Team is supported by dedicated and professional administrative staff as well as our dedicated team of volunteer who provide countless hours of support and services to our patients. THANK YOU, WITH MUCH GRATITUDE Mountain Valley Hospice is grateful for the generosity of so many donors, staff members, volunteers, board members, and community partners who made it possible for our team to participate in the care and support of patients, families and caregivers throughout Fulton, Montgomery, Hamilton, and Saratoga Counties. It is because of this generosity that Mountain Valley Hospice is able to offer services to all who need them.

HOSPICE ADMISSION LOCATION 10% 29% 7% 54% Home HH Hospital Nursing Home REFERRAL SOURCES 3% 11% 26% 13% 47% Physician Hospital Family Community Agencies Other LOCATION OF DEATHS 6% 11% Home NDHH 29% 54% Hospital Nursing Home Patients By County 2% 2% 26% 70% Fulton Montgomery Hamilton Saratoga

Diagnosis of Patients 11% 19% 9% 12% 49% Cancer Cardiovascular COPD Neuro Other TOTAL ADMITS: 283 TOTAL PATIENTS SERVED: 318 Admission By Race Caucasion African American Asian Patients By Age 0-40 41-59 60-64 65-74 75+

Financial Summary for 2015 Total Days In Each Payor Category 0.10% 0.70% 0.10% 0.90% 9% 89% MC MA Private Charity Inpatient MC Inpatient Private TOTAL EXPENSE BY TYPE 5% 77% 18% Management & General Program Services Fundraising TOTAL REVENUE BY TYPE 15% 5% Medicare Medicaid 5% 8% 54% Commercial Room and Board 13% Fundraising/Donations/M emorials/grants Foundation

2015 Board of Directors Members: Jack Scott- Chairman Susan Hathaway-Ringland- Vice Chair Susan Putman- Treasurer Earl Johnson- Secretary Clayton Sitterly Tina Delaney Kathleen Wolfe Roderick Correll Daniel Ehle George Doherty Dr. Frederick Goldberg Barbara Nigra Sue McNeil Michael Countryman Mark Kilmer 2015 Foundation Board of Directors Susan Kiernan- Chairman Theodore Hoye- Vice Chairman Lisa Queeney- Treasurer Jeremiah Wood Esq.- Secretary Clayton Sitterly- Liason Kathleen Wolfe- Liason John Stewart Donald Fleischut Thank you to our board members for all of their service and dedication to Mountain Valley Hospice.