A message from Bob Franko, CEO
Dear Friends and Supporters of the VNA Hospice of Northwest Indiana:
A recent social media post raised some concern from community members about the practices of the VNA Hospice, specifically about how we operate our Arthur B. and Ethel V. Horton Hospice Inpatient Center. The question was posed if the VNA Hospice changed its admission criteria to the Hospice Center so that patients and families can no longer utilize the facility at no charge. This started a long string of replies that escalated to the point that some advised that perhaps donors should no longer support the VNA and that the current director changed the mission of the Center and doesn’t care about people.
I am that current director. My name is Bob Franko and I’ve had the privilege of being the President/CEO of the VNA Hospice for the last four years. I’m happy to address this concern—but before that, I’d like you to know I’m always available to answer questions and talk about our services. You can call my office any time at (219) 531-8053 or email me at firstname.lastname@example.org. I’d also like to add I completely understand this concern and am always happy to chat with folks about YOUR VNA Hospice.
I can’t speak much about how the Center was managed ten years ago, but I’ll take folks at their word that they believed the services were free of charge and that it was a beautiful, peaceful place for their loved ones to stay at the time of their passing. It still is a beautiful, peaceful place, I can assure you. I’ll not bore anyone with the specifics of the Medicare Hospice Benefit—you can certainly Google it to learn more—but I will share that there is a large gap between what Medicare pays us for a day of service and what it costs to provide that care. That gap is as much as $1,200-$1,400 a day for our inpatient center for most patients under Medicare’s routine level of care. We ask families to help us close that gap with a fee that doesn’t even come close to the daily loss, but at least helps us maintain operations. For those that can’t afford that fee, we offer a sliding scale based on income, expenses and family size; we further take into account other factors to help determine the level of reduction we can provide. The lack of adequate funding for that vital service is our problem, not the patient’s. Each year we subsidize through charity care, reduced fees and write-offs over $1.3 million in care. No other private, for-profit hospice in our area—or anywhere for that matter—would subsidize a shiny nickel, let alone more than 25-percent of its operating budget.
We had a choice to make near the start of the COVID pandemic: to either close the Center or realign our admission criteria to better meet the true purpose of the Center and to focus on high-need patients – those who have severe symptoms like pain, breathing difficulty and anxiety that are too difficult to manage at home or in a nursing home setting. Medicare does make an allowance with an enhanced rate for this level of care, but it is highly regulated and scrutinized by the Office of Inspector General. This wasn’t a particularly difficult decision. Our goal was—and continues to be—to maintain this vital resource for our community. There are only seven such hospice inpatient centers left in the entire State of Indiana (all operated by non-profits) and we aim to maintain this valuable facility for our friends and neighbors, but we can’t do that by sustaining massive losses. Even with the generous support of donors and those who attend our fundraising events, it is not nearly enough to close the gap on the losses. I suppose this is where there is often confusion; some folks believe that since the VNA Hospice is a non-profit, or “charity”, that we don’t charge for our services and that donors cover the cost. I wish it were the case, believe me. As it is, I am eternally grateful for our past and current donors and pray that they know that every dollar they give help Make Best Days Possible for hospice and palliative care patients, Meals on Wheels recipients, Medical Guardian clients and kids in our Phoenix Center—more than 600 people a day in our services.
Please know we work diligently every day to meet our mission and maintain this vital resource for our community. Our relationship with our community is built on trust and understanding, you are our stakeholders. There are times that tough decisions need to be made to assure that we are the best stewards of our resources and reinforce our foundation for another 53 years of dedicated care. And please know that as the CEO of the VNA Hospice, I care about people—it’s the most important part of my job. Our entire team is made up of the most caring and compassionate people I’ve ever met and we’re all grateful for your support.
Thank you for your time.