Hernando-Pasco Hospice Inc. tries to get its foot in Citrus, which a report shows has unmet needs, as Hospice of Citrus County expands in Spring Hill.
By COLLEEN JENKINS
Published May 4, 2004
Hernando-Pasco Hospice Inc. is again asking the state for permission to expand into Citrus County.
Last year, the Agency for Health Care Administration granted the nonprofit organization a certificate of need, which certain health care providers in Florida must receive before offering new or expanded services.
But Hospice of Citrus County immediately challenged the decision, tying up its competitor's plans until an administrative hearing settles the issue.
In a strategic move, Hernando-Pasco Hospice has filed a second letter of intent with the AHCA. This time, the organization cites a recent AHCA report that indicates Citrus County has unmet hospice needs.
The out-of-county organization frames its most recent application as an effort to ensure Citrus County residents have sufficient hospice services at their disposal. But the new chief of the county's current hospice organization is skeptical about his competitor's motives.
"It's basically an attempt to wear down the opponent," said Anthony J. Palumbo, chief executive of Hospice of Citrus County. "We don't use that strategy. We won't use that strategy."
Hospice organizations are private entities independent of one another.
Such a tug of war seems more likely to be played out in corporate boardrooms than between nonprofit organizations. But AHCA officials say the strategy employed by Hernando-Pasco Hospice is common for organizations serious about becoming a provider in an area.
In this case, Hernando-Pasco Hospice points to the low percentage of Citrus County residents being cared for by their sole hospice provider. Last year, Hospice of Citrus ranked at the bottom in the state by serving 34.1 percent of the people who died in the county.
In contrast, 56 percent of those who died in Hernando County received hospice services, said Hernando-Pasco Hospice spokeswoman Robin Kocher. The state average was 47.9 percent.
"We have already been well above the state averages in meeting the needs and taking care of a large percentage of the dying population," she said last week. "We just feel that Citrus deserves the same."
Kocher said the case was bolstered by the latest AHCA needs projection report. Every six months, the state agency determines an area's need based on reported deaths, population projections and admission numbers for existing hospice programs.
The most recent figures suggest Citrus County has enough unmet need to warrant an additional operation.
"When we show need, the admissions trend for the existing programs is relatively slower than the growth rate for likely candidates to use the services in the future," said Jeff Gregg, chief of AHCA's bureau of health facility regulation in Tallahassee.
However, it's unlikely AHCA will approve Hernando-Pasco Hospice's second application. That decision won't be made until August, but Gregg said the agency typically doesn't approve an application when it has already granted a certificate of need for essentially the same proposal by the same organization.
But Kocher said Hernando-Pasco Hospice felt compelled to renew its application because the organization can't move forward with its expansion plans until an administrative hearing is held to deal with Hospice of Citrus' appeal. That hearing is scheduled for July.
Palumbo said the competition's reapplication was not on the top of his priority list. Though he expects to prove that Hernando-Pasco Hospice's contention of unmet need is invalid, Palumbo said he is spending more time focusing on Hospice of Citrus' efforts to become more viable.
"We're on the upswing," he said.
The local hospice board just approved construction of an inpatient facility, and Palumbo expects building could start by late summer. The patient census is up by 10 percent, he said.
As of May 1, Hospice of Citrus County has expanded its Comfort Home Care division into Hernando County.
The home health care arm already had been serving Citrus' southern neighbor but now will look to increase its case load with the opening of a new office, said Phyllis Peters, director of home care services for Hospice of Citrus County.
Nurses and staff members serving Hernando County residents will use the dropoff site in Spring Hill as a more local base for completing paperwork.
Though the decision to broaden the home health care services may appear to be a response to Hernando-Pasco Hospice's efforts, Citrus hospice officials said the division had long been licensed to serve that county.
"We're just expanding because the need is there," Peters said.
Palumbo said he is confident about Hospice of Citrus County's future, regardless of how the appeal process turns out.
"There's always going to be an enemy at the gate," he said. "We can compete effectively."
