from The Journal, NFDA Publication
October 11, 2012 • Vol. 3 No. 41
This Issue:
Committing to Culture Change....................................................... P. 1
OSHA Issues Penaties, Citations Against N.C. Funeral Home.... P. 8
The Notebook................................................................................... P. 9
From the Editor’s Desk.................................................................. P. 10
Committing to Culture Change
Life Celebration Creates Alliance with Nursing Home,
Hospice to Re-imagine the Continium of Care
Explaining the Process
Ken Neeld Jr., has been working with healthcare organizations
since 2007 to develop an experience based
patient care model, currently chairs the group
responsible for the development of “Adding Life to
Years,” a Life Celebration platform created for/ with Genesis
and another hospice program.
Neeld explains the process that initiates a discussion
about funeral arrangements in a nursing home (SNF),
which is different than the conversation initiated with patients
(consumers) in hospice. "Simply, the conversation about "buying" a funeral is part of the business process for nursing homes and more financially based. The conversation in hospice is more social service driven, as hospice tends not to manage/ advise on the finances of their patients."
Generally, what can we observe about our aging population?
A basic recognition that there is a spike in both the
aging population, and corresponding spike in the applicants
for Medicaid is important. The body that regulates
Medicare and Medicaid guidelines: the Center for Medicare
and Medicaid Services (CMS) established the ability
for consumers to fund an Irrevocable Trust to pay for future
end-of-life expenses.While helpful to a previous aging population, it is critical for today's aging population to retain some of their funds for future expenses.
Why do nursing homes ask residents to “buy” a funeral?
The process of entering skilled care typically initiates a
cascade of events. Simply, those events are expensive for a
mostly senior population. Beyond clinical care, an important
function of the nursing home is to secure payments
and maintain a continuity of payer-source.
As an individual enters an SNF or nursing home, they
will experience one of several outcomes: discharge after
(average) of about two or three months (if a rehab patient) or admission
as a long stay resident. The vast majority of individuals
that transition to a long stay resident end up
depleting assets- with many long stay residents now converted
to Medicaid as their payer-source.
Why is a pre-paid funeral trust sometimes designated as Irrevocable?
The Irrevocable Trust in fact was established as a
preservation tool to allow consumers to retain a predetermined
amount for future expenses which include the
funeral as they now had sufficiently depleted funds to
qualify for Medicaid. In effect, the conversation about
a funeral is really a conversation from the nursing home
that says “ We want to be sure that you have allocated sufficient
funds for end of life expenses that include a funeral-
especially considering you will likely be out of money
in x months”. This is part of the Medicaid planning process,
and thus a question on the application because it is
really a CMS directive first and NOT a selling tool for the funeral industry first.
So what happened?
Respectful of us all in funeral care- a funeral
is an “unsought” good vs a “sought” good that consumers actively want to purchase. This really then begs the questions: 1) Do you distinguish between consumer needs and
desires, and 2) how much is too much to pay for something
you don’t really want?
Is this a problem or opportunity for funeral service?
Unfortunately, senior healthcare providers share the
same consumer perception of the funeral industry as the
rest of the country- which is negative. Interestingly, healthcare is also driven by "functional or needs-based" systems, much like the funeral business has been "directed by the FTC and State Rules and Regs. The challenge is to go beyond what "we" are made to do, and re-assess what families, consumers, patients, residents would LIKE for us to be. The answer I am finding is that often it is the very opposite of what we have been doing.
Most unfortunate is that consumers have proven, better outcomes and experiences
when those segments of industry responsible for care work together. This is the foundation of the
Mayo Clinic model. The foundation of Enhancing PatientCare by Life Celebration redefines the “Care Team” to include all disciplines within nursing, hospice and funeral- but with re-defined roles.
The opportunity lies in those providers
that can transform themselves to add value to the industry
segments “upstream” – hospice, nursing homes, in-home
care providers, etc. Simply, we must convert our offerings
from “unsought” to a “highly sought after” offering which
I assure you can be done but only by truly understanding what your customer truly "values".
MBJ
