Earlier this month, Van Gorder announced that Scripps had purchased the much smaller Horizon Hospice in suburban Poway, in essence giving Scripps a license to deliver hospice care. Van Gorder is careful to say that Scripps is not "purchasing" San Diego Hospice, because that would mean absorbing any debt and liability the hospice will owe CMS, "which we obviously can't do."
Clearly, however, Scripps would be positioning itself to provide many of the same services. Van Gorder adds that having a hospice within its continuum of care, something Scripps essentially lacks, makes sense for all sorts of reasons. "We are moving incrementally back into managed care, capitation, bundled payments—all those things," he says.
"We do believe we have to knit together this extremely fragmented delivery system and make more common sense out of cost, quality of care and continuity of care."
Last year, Centers for Medicare & Medicaid Services audits determined that San Diego Hospice was treating patients who did not have physician documentation that they would die in six months, in violation of CMS rules. Because of that, SDH faces the possibility that it must repay millions of dollars to the federal government in overpayments.