VNA NWI Hospice spotlights mission, struggles during visit by Mrvan

During a Monday tour of Valparaiso’s VNA NWI Arthur B. and Ethel V. Horton Hospice Center, U.S. Rep. Frank J. Mrvan, D-Highland, asked questions about the services the facility provides, while President and CEO of VNA NWI Bob Franko explained the challenges of running a nonprofit hospice.

Mrvan had requested a tour of the hospice, according to VNA NWI Community Liaison Amy Wulf, and he spent nearly an hour at the facility, meeting the staff and discussing with them how he might be able to help them in Washington.

Franko had met Mrvan a few times in the past, and said he hoped he would be able to explain to the Congressman how the facility works and the things it needs to work more efficiently. He lamented throughout the morning about the rise of for-profit hospices and the difficulties they bring.

“We want to make sure (Mrvan) is educated about what we do and our challenges,” Franko said. “There’s very few nonprofit hospices left in the U.S. This was never supposed to be lucrative — we were just supposed to fill a need.”

“(VNA NWI) continue to provide a broad range of care for patients and families, but frankly, it’s expensive,” he added. “We take care of everyone regardless of their ability to pay.”

Decades ago, the majority of hospice patients received care from nonprofits, but today nearly three quarters of hospices in the U.S. are for-profit, according to a recent report in the New York Times.

Franko criticized for-profit providers for “profiteering” at the expense of patients, a criticism that has become increasingly common in discussions of hospice care. A report from MedPAC found that for-profit hospices received 20.5% more from Medicare than they actually spent on services in 2020, compared by the 5.8% margin received by nonprofits.

“We don’t treat people as commodities,” Franko told Mrvan during the tour. “People aren’t just widgets to be thrown away as soon as they’re not profitable anymore.”

During the visit, Mrvan heard stories about families who have received care and support from VNA hospice, which emphasized the importance of accessible and high-quality end-of-life care services for the community.

VNA NWI is one of only seven providers in Indiana with an in-patient hospice center. The hospice serves over 600 patients a day. Wulf said the nonprofit’s nurses, social workers and other employees receive over 23,000 patient visits a year, the overwhelming majority of which are patients who receive in-home care.

Before Mrvan arrived at the facility, Franko praised him as someone who is “community-minded” and seeks to understand his constituents and their needs. Mrvan and Franko spent most of the tour discussing problems nonprofit providers face and legislation the VNA NWI hoped Mrvan would champion in Congress.

Mrvan said he would have to review most of the legislation, but the two did agree on the “Improving Access to Transfusion Care for Hospice Patients Act of 2021,” which if enacted would “require the Center for Medicare and Medicaid Innovation to test allowing blood transfusions to be paid separately from the Medicare hospice per diem payment.”

The VNA NWI receives the overwhelming majority of its funding through Medicare, and Mrvan said he supported increasing funding for Medicare, criticizing those in Washington who want to cut spending.

“You have a partner and an advocate in D.C.,” Mrvan said to Franko during the tour.

Mrvan said he wanted to tour the VNA NWI Hospice because it “makes (him) a better member of Congress” to meet the people in the communities he represents. He was warm and cordial with the staff, taking the time to meet and talk with each one of them throughout the morning.

“It’s a phenomenal facility, and the people who work here are phenomenal,” Mrvan said. “You can tell the people here care about the community.”