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Hospice not sure of plans

Fargo soon will have two more end-of-life care options for terminally ill patients, leaving the longstanding Hospice of the Red River Valley with mixed emotions.

Fargo soon will have two more end-of-life care options for terminally ill patients, leaving the longstanding Hospice of the Red River Valley with mixed emotions.

For more than 20 years, Hospice has been the region's only specialized end-of-life caregiver.

That will all change in the next few months as a second hospice gets set to open at 2902 S. University Drive and a palliative care unit is added to MeritCare Hospital's South University facility.

Hospice has embraced MeritCare's new palliative care unit, meant to complement hospice services.

"We're very supportive," said Susan Fuglie, Hospice executive director. "This is not a competitor for us."

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At the same time, the new hospice -- operated by the for-profit, Texas-based Odyssey HealthCare -- will be in direct competition with the current hospice, for patients and for volunteers.

Odyssey will receive Medicare reimbursement, so law requires at least 5 percent of their work be done by trained volunteers.

About 10 percent to 13 percent of Hospice's work is done by volunteers.

Odyssey already is set up in its Fargo office, but it may be up to six months before patients are accepted, said Jenny Haynes, vice president of Odyssey communications.

Laurens Robinson, who moved here a week ago from Baytown, Texas, will run the new Fargo hospice.

Haynes, spokeswoman for the Fargo facility, said Robinson is in the process of hiring employees, getting established in the community and obtaining a license to practice in North Dakota. So far, things are going well, she said.

Robinson previously said he hopes the addition of another hospice will benefit the entire community and said he sees the already-established Fargo hospice as a partner in end-of-life care.

But Russ Tweiten, president of the Hospice board of directors, takes exception to the claims. Hospice isn't against competition, but is opposed to the idea of making a profit on dying people, Tweiten said.

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"That's just not what we're about," he said.

Odyssey, one of the largest providers of hospice care in the country, also may bring big money for marketing campaigns, forcing Hospice to divert resources and time to do the same, Tweiten said.

"If we have to do it, we probably will," he said. "But if we spend $15,000 on a campaign, that's $15,000 that doesn't go back into Hospice."

Tweiten said Hospice isn't concerned about the same happening with MeritCare.

"At first we were a little taken aback," he said. "Once we talked to them, though, we were more comfortable."

The palliative care unit, which will have eight single rooms with hotel furnishings and private baths, is scheduled to open in October.

The biggest difference between the hospices and the palliative care unit is that hospices rely on Medicare reimbursement. When a person moves to the palliative care unit, it's no different than moving to a different floor of the hospital, said Dr. Preston Steen, the MeritCare oncologist who will head up the new unit.

Also, a person entering hospice care may be in it for up to six months. At the palliative care unit, the typical stay is one to two weeks, Steen said.

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It's by chance that two similar facilities are opening in Fargo around the same time, Steen said. MeritCare has been planning the addition for more than a year, he said.

Coincidence or not, Fuglie said more people nationwide are seeking specialized end-of-life care. The trend is true in Fargo, too.

"We're experiencing a real culture shift. Five, 10 years ago, (dying) was a taboo topic," Fuglie said. "More and more, we're understanding the need to plan."

For Hospice of the Red River Valley, that means considering what additional end-of-life care needs Fargo might have in coming years.

For example, Hospice is in the process of conducting a study to determine if it would be feasible to build a Hospice House in Fargo.

This would be a place where dying patients could reside, especially those who need a higher level of care than they can get at their home. The study could be complete later this year, Tweiten said.

"If we think there's a need, we'll go to the community and ask them to help us," he said. "But first we want to make sure this is something we really want to do."

Readers can reach Forum reporter Mary Jo Almquist at (701) 241-5531

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