For Our Intended Partners:

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It is the heart, of Grace Hospice of Missoula County, to provide end of life care, at no cost. Grace Hospice is funded, solely, by donations of kindness and goodwill.

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Grace Hospice of Missoula County is a 501(c)(3) “no”-profit organization, registered with the IRS, Montana Secretary of State and licensed by the Montana Department of Public Health & Human Services.

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Grace is comprised of a small team of registered nurses with greater than 41 years of collective hospice experience. In our experience, hospice has been an invaluable tool, an opportunity to ensure comfort and expert care for a most vulnerable population, a community of individuals nearing end-of-life. Grace views the journey of end-of-life as sacred and understands the magnitude of the impact of presence, compassion and trusting relationship between a patient, family, physician, and hospice team.

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Grace acknowledges that there is one single opportunity afforded to each individual and team to “do it right and do it well.” It is at the intersection between patient autonomy and Medicare mandates that we find ourselves in direct contradiction with our goal. Though essential, federal mandates and policies conflict with the patient’s right to choose, promoting the notion “I have to choose between all or none.” The restriction of choice is most often the fundamental reason patients and families refuse or delay beneficial hospice care. They are simply “not there yet.” Lack of hospice services, interventions and support frequently result in increased suffering, unmanaged symptoms, and an overall feeling of uncertainty for surviving loved ones.

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We have noted that hospice services, in the form of skilled nursing assessments, medication management, mechanical interventions, personal care assistance and spiritual support, often result in improvement of symptoms associated with disease process. Symptom management is key to ensuring quality of life. Improved quality of life often results in longevity or a slowing of disease progression. With stabilization, improvement or lack of decline, Medicare compliance requires withdrawal of hospice services in the form of “graduation.” Graduation is a revocation of supportive services, critical assessments and interventions provided by the hospice team. Fear of graduation, loss of in-home care and relationship with the hospice team is the primer behind the commonly spoken words “I want to feel better but not too better.” It is here that we, as a team, began to challenge “the way it’s always been done.” “Why can’t a patient receive curative treatment, undergo procedures or diagnostics, and receive specialized care? Who decided that a patient must choose between all or none?” We, as an organization, recognize the fiduciary responsibility of federal entities but we emphatically challenge the restriction of pursuit of curative treatment for hospice appropriate patients. Autonomy dictates choice and when choice is removed, we must reassess. The founding team of Grace reassessed and found an alternative, one that maintains autonomy, ensures compliance with federal guidelines, and allows for a patient to “walk out” their journey, their way and in their time.

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Grace is an alternative to traditional hospice care, only in the sense that we do not receive, or accept, federal funding. We offer identical services, without the restrictions imposed by the “election of hospice benefit.” What that means is that you can continue to treat, seek cure, provide palliative care, engage diagnostics, and manage your patient’s care while your patient receives hospice care in the home.

 

How it works:

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• Grace does not receive funding from Medicare, Medicaid, private insurance, or private pay. Because we are not federally funded, we do not require a signed election of hospice benefit. This means funds available for curative or prolonged treatment remain available for utilization by the patient.

• A hospice referral is required.

• Certificate of Terminal illness is required.

• You remain the attending physician. Grace does not employ a medical director.

• Your patient will continue to utilize their Medicare, Medicaid, personal insurance, as they have thus far. You can continue to monitor via diagnostics, in office visits and admit to hospital as you and patient deem necessary.  If hospitalized, Grace will continue to provide support, no revocation required because no election of benefit has been signed.

• Medications will continue to be paid for via Medicare, Medicaid, or private insurance. If a patient or family cannot afford comfort medications, Grace has partnered with 406 Pharmacy, to supply medication required to ensure comfort, at no cost.

• Wound care, IV/POC/PICC, urinary catheter and incontinence supplies will be ordered via medical supply outlet with Medicare, Medicaid or private insurance as pay source. Grace has ample donated supplies that may be utilized to ensure no delay in cares required or recommended.

• Equipment will be provided by local DME, requiring coordination to ensure essential supplies are in the home and in place at time of admission. DME will be paid for by patients Medicare, Medicaid, or private insurance. Grace does receive DME donations and will supply, as needed, and when in stock.

• Grace provides care in home, ALF, independent living facilities and support to patients admitted to hospital.  Grace does not provide care in SNF, we must utilize our nursing staff where most needed.

• Grace is funded by community partners and businesses who share in the idea of “kindness when there is no cure.” Our patients, your patients, will never receive a bill from Grace.

• Grace’s nurses are available 24 hours per day, 7 days per week.

• Grace will have weekly IDG meetings and will provide written POC updates if you are unable to attend in-person or virtual. POC’s will be submitted for signature, in addition to prompt notifications of changes in condition. We welcome your guidance and expertise.

• Grace’s team and administrative staff pledge to maintain prompt, productive and open communication to ensure that your patients receive timely, accurate and effective care.

 

Grace Hospice of Missoula County is committed to excellence, in service and in partnership, with our valued community of extraordinary physicians. We are the 3rd “volunteer” hospice in the United States. We invite you to join us, revolutionize hospice care and change “the way it’s always been done.”

 

We welcome you to Grace!

If you have questions, concerns or wish to know more about Grace, please contact us.

 

With Sincerity and gratitude,

Grace Hospice of Missoula County