The Truth About Hospice in Palm Beach County

To our community

The Palm Beach Post published a story about Trustbridge on Sunday June 17.  This story was also distributed online. It is the same type of story they have done in the past, clearly intending to put our company in a bad light in the community.

The story relies on partial facts, unsubstantiated allegations by two former employees and outdated information. It questions the commitment of our leadership and denigrates our volunteers. While we provided The Palm Beach Post with extensive, factual information for their story, they chose to use only a minimal amount. We want our community to have the full facts regarding questions raised by the Post, and are offering them here.  We hope you will take the time to read them.

Salaries 

The Trustbridge Board of Directors continues its 40-year commitment to providing the highest quality care possible to its patients and their families, and providing a positive working environment for its employees.

The story compares our executives’ salaries with those of executives at the School District of Palm Beach County (a government entity) and the United Way of Palm Beach County (a coalition of charities).  We are a highly regulated health care organization that employs doctors, nurses, pharmacists, and other health care professionals. A more accurate comparison would be to Boca Raton Regional Hospital, Jupiter Medical Center, Bethesda Hospital East and West or other hospice care organizations in our area. 

We follow a process to set compensation.  Each year the board contracts a nationally recognized healthcare compensation expert to review and update executive compensation within the hospice peer group and the healthcare industry in which we compete. Their compensation committee reviews and approves the consultant’s recommendations. 

To attract and retain people with the talent and experience needed to operate our $139 million healthcare business, with approximately 1,400 employees and 650 volunteers serving more than 1,900 patients a day across two counties, the committee targets executive compensation to fall within the 50-75% market bracket. The entire executive group falls well within the 50-74% range. 

Our Human Resources department conducts a similar review each year to determine the ranges for each position in the company. This evaluation relies on local, state and national healthcare compensation data. The review includes all components of compensation, including salary, benefits and rewards. 

We use the same target for our staff as we do for our executives: 50-75% range in the market. 

Despite the serious funding reductions from CMS and increasing expenses for services we have sustained our workforce levels, salaries and benefits without cutbacks. 

Our company has achieved a very stable position over the past few years, adapting and responding to market and regulatory changes, while continuing to provide our patients quality care and supplies and our teams with a stable and reliable company to work for. We have had no layoffs in over six years, and we have no plans for any.

Charity versus Not-for-profit

Trustbridge has a charitable organization in addition to our not-for-profit business. They are separate operations with distinct missions. They function under different regulations.  It is inaccurate to conflate the two. Our charitable foundation helps pay for services and supplies that are not required or not covered by Medicare or Medicaid but which provide support to our clients.   

Volunteers

The story dismisses our volunteers as “unpaid labor.”  Medicaid and Medicare regulations require us to enlist the help of volunteers. We could not fulfill our mission to our patients without them and our community benefits greatly from their important work.  

Patient Care

We are proud to be the largest hospice service in Palm Beach County that accepts patients regardless of their ability to pay.

As the only Joint Commission rated Gold Seal Standards hospice service in Palm Beach and only one of two in Broward County, our commitment to the industry’s highest standards is both evident and independently measured.

Members of our community should always demand this level of care. We have been caring for patients facing end-of-life decisions and complex medical conditions for 40 years and we understand when family members, in times of great emotional distress, set expectations that are not attainable. 

Of the 12,079 patients we served in 2017, we received only six (6) AHCA complaints. We were only cited for three (3) of those and we quickly corrected those deficiencies. Year-to-date (2018), we have received 5 complaints, with no cited deficiencies, while serving 6,732 patients.

Over Payments

All Medicare and Medicaid providers are subject to continuous, routine audits and reviews as part of the oversight process. In these two cases auditors reviewed our records and asserted a small overpayment amount. 

One review covered a three-year period starting in 2008, with a claimed overpayment of $181,185, with no fine. 

The second covered a three-year period starting in 2009, with a claimed overpayment of $748,784, with a penalty of $149,756. During this period our total Medicare/Medicaid payments were approximately $363,444,301. 

The total claimed overpayments were less than 0.002% of our payments. Our internal investigation determined that the payments in question largely involved technical billing issues. In neither case was there an assumption of wrong doing by the government.

Trustbridge is routinely recognized by government agencies, peers and independent surveyors as one of the nation’s best. 

We regret any concerns this story may have caused to the hospice care community. We are fortunate to have deeply committed staff members, volunteers and supporters, all of whom strive every day to help our patients and their families through one of life’s most challenging experiences. Over the last three years, we have provided comfort, support and medical care to 32,223 people, regardless of their financial circumstances. We intend to continue this work for many years to come.

Dave Fielding

Chief Executive Officer