Trustee letter for Nathan Adelson Hospice, September 1986

September TRUSTEE LETTER SEPTEMBER ADMISSIONS REBOUND FROM AUGUST LOW During a whirlwind round of face to face meetings with our primary referral physicians, I learned that some of them objected to comments made at our last full Medical Staff meeting concerning what is "appropriate" hospice acute care and what is not. A few physicians occasionally insist on tube feedings (which, in the case of end stage cancer, often causes the tumor to grow) and I.V. Morphine when other less instrusive methods of pain control are available. I'm meeting with the physicians that utilize us the most in their offices and I've generally found them to be supportive and their observations to be helpful. We only had 22 admissions in August, but as this goes to print, we've already had 29 admissions in the first 19 days of September. Home Health has also rebounded with a census of 76 and the facility has 17. TRUSTEES EXPERTISE HELPING HOSPICE Of course we need your checks, but let me share the way trustee involvement, in addition to monetary support is helping us. Don Baepler is researching Gov't and private foundations to identify those most likely to fund grants for our program. Don has agreed to use his well known magic pen to author proposals on our behalf. Valley Hospital Administrator, Ernie Libman, has been advising me on reimbursement trends that will impact hospice and has offered to help get our community's for-profit hospitals together to assist us in everything from purchasing power to general support. UNLV Nursing Dean Mary Ann Michel is authoring several articles for medical journals using the NAH history and documentation as the basis for her research. Irwin Molasky and Al Benedict have reviewed our facility operating budgets and procedures and made suggestions that helped us trim thousands of dollars in areas removed from direct patient care. Herb McDonald helped us (and Las Vegas Events) by leasing one of our mobile signs to promote the hydroplane races at Lake Mead. He has also committed to "several" signs for the big National Finals Rodeo in December. Herb, along with Denny Weddle (Suma), Joe Esposito (Bally's) and Clair Haycock (Haycock Distributing) who, by the way, also commited to a donation of 1,000 gallons of gasoline, have been meeting TRUSTEES EXPERTISE HELPING HOSPICE (CONT.) with non-board members, Dave Jamison, United Expositions; Bill Jones, Greyhound Expositions; and Bob Schmuck, LVCVA to develop a campaign to sell our Las Vegas Access books. Jamison is also including sign brochures in convention exhibitor's binders. Ray Norvell, NAHF Vice President, has another golf tourney he's working on and he's got some ideas about the Access books too. Jan Jones reminds all of us to buy our new cars from Fletcher Jones in November when $10 from each sale goes to the NAH. Muriel Stevens dedicated her talk show to hospice on September 17th and I was her guest. The show went very well and hopefully we reached people out there who really need us and have gotten them thinking about hospice. Fred Lewis, Fred Lewis, Inc. has offered his guidance in developing a well thought-out twelve month publicity strategy to bring the NAH program benefits into the homes of Southern Nevada with our "Shoulder to Lean On" campaign. Steve Cohen returned a recent call several minutes before Sam Lionel could free himself from a deposition and call back. It's great to have such first rate legal advice at my fingertips. Dr. Bill Stephan continues to find ways to help our program. Bill was instrumental in guiding the CNB trailer to us and he is now helping position hospice in relation to the health maintenance organizations which are rapidly capturing a significant portion of the Medicare population. PUBLIC SERVICE ANNOUNCEMENTS NOW BEING AIRED Thanks go to our local television stations and Steve Strout of Backstage Productions. The hospice ten and thirty second "A Shoulder to Lean On" spots are helping us reach into the homes of terminally ill Southern Nevadans. In some cases the only way a physician will refer the patient is if the patient asks him/her, "What about hospice?" I'll be happy to explain why, when we have a chance to sit down and talk - maybe you can help. NAH ON Besides our public service announcements I'd TELEVISION like to thank Channel 3 for having us on Donna Cline's Dimension 3 show. We are also scheduled on Channel 5 with Deborah Campbell on "A.M. Southern Nevada" and Channel 13 is taping 10 minute segments for NAH volunteer recruitment. Volunteers and staff involved in these spots are Shannon Hamilton, Jim Sugden, Gary Gardia and Dee Powers. We thank these people for their time in allowing us to spread the hospice philosophy through the media of television. THE "HEART OF HOSPICE" - OUR INTERDISCIPLINARY CARE TEAM A reminder about what is "unique" about our care. As you know, every hospice patient is monitored daily. These cases are reviewed constantly, On a weekly basis, our whole Interdisciplinary Care Team convenes for about two hours and the nurses, Medical Director, social workers, clergy, administrators, volunteers, etc. discuss the changes in the patients' conditions. We also talk about the patients' families and/or support network deciding to increase volunteer support for one; call an employer to get time off from work for the husband of another or arrange pastoral care for a spouse. If our nurses suggestions to a physician regarding a more effective pain control procedure have gone unheard, our Medical Director makes that important and sensitive peer-to-peer phone call; hospice team members are regulary assigned or volunteer for individual bereavement follow-up. The team works on the assumption that the resources will be there when we need them. The interdisciplinary team's sole concentration on the patient and family's needs is what guarantees the absolute quality of our hospice care. HOSPICE With 90% of our more than 120 hospice team members FISCAL appropriately focused on the delivery of top MANAGEMENT level care, who manages our resources and what controls are in place to insure that our limited funds are applied in the manner that will do the most good? As heavy Medicare providers our program is closely regulated and reviewed. Our reimbursement is also reviewed by insurance companies and other health maintenance systems. The hospice Department Heads manage their individual budgets and variances are regularly reviewed as in any service business. We also have a new and very effective control team that has been operating for several weeks. This team looks at our patients from a little different perspective . . . The Discharge Planning Team. Every day at 3:30 p.m. I meet with our Medical Director, Dick Weisner; Administrator for Patient Care, Rita Rosanski; Medical Records Director, Janis Dionne; Social Workers, Judy Harrington and Billy Taylor; Business Office representative, Pat Cooper; Director of Volunteers, Dee Powers; and my assistant, Lepha Roed. This group reviews every patient in the facility and every proposed admission to insure that the most medically appropriate and cost effective hospice care is being provided. If staff feels that a patient is no longer acute or wi. 11 soon have his/her acute symptoms controlled, this group determines who will take what course of action to alert HOSPICE the physician or talk with the family. In an FISCAL intensive nurse/patient, twenty bed facility, MANAGEMENT there is no margin for error. One medical admission (CONT.) that receives heavy medication for an extraordinarily long length of stay can eliminate an entire quarter of tight fiscal management. AMERICAN SOCIETY OF HOSPITAL PHARMACISTS Billed as "the world's largest gathering of pharmacists" the 21st Annual ASHP Clinical Meeting is headed for Las Vegas. The Nathan Adelson Hospice has agreed to conduct a presentation and lead a panel discussion on hospice interdisciplinary team care on December 9th at the Convention Center. We will be introduced by National Hospice Organization President John J. Mahoney. We will focus on "The Pharmacists Role in Hospice Care". It is a pleasure to once again find NAH in a national leadership position, especially when it comes to assisting in building hospice awareness in the medical arena. HOME HEALTH & FOUNDATION ANNEX More donations have arrived to help our Physical Plant Manager, Leroy Gamble, as he continues his one man quest to prepare our 2,100 Sq. Ft. structure (triple-wide trailer, contributed by Continental National Bank) for mid-October occupancy. A1 Benedict brought Russell Karsten through the hospice and Mr. Karsten arranged to have Hansen Mechanical Contractors do our trenching and plumbing. Mr. Bob Ray responded to a call from Russ and Dynalectric Co of Nevada has provided all of our electrical needs. The hospice is blessed to provide our care to a community that is so responsive to our call. NATIONAL HOSPICE ORGANIZATION'S ANNUAL MEETING NOVEMBER 16-19 The title for this year's annual meeting is "Sharing the Spirit" which acknowledges and recognizes the multi-dimensional concept of "caring" that is basic to hospice. The NHO meeting is the largest and most prestigious national symposium in hospice and the NAH has been selected as the host for next year's annual meeting. I was pleased to be notified by the NHO that my presentation entitled "Hospice Mobilization - Cost Effective Utilization of Private Funds" has been accepted as a workshop for the 1986 Annual Meeting and Symposium of the NHO. This is my second year as an NHO faculty member. As noted in last month's Trustee Letter, our Medical Director, Dr. Richard Weisner, will also be a participating faculty member this year. GENE WARD We receive many memorial gifts. Memorial donations ELEMENTARY SCHOOL are an important part of our budget. They are CONTRIBUTES TO also an indication of the hospice's impact on NAH our community. Most of the notes that accompany these contributions are personal expressions of appreciation, sometimes groups write to us. I thought you'd be interested in an example of the latter: "Last Spring our school librarian, Betty Jo Lamb, was a patient at Nathan Adelson Hospice suffering from terminal cancer. After she passed on, the students, staff and parents of our school raised money for a memorial to Betty Jo. Part of the funds were to be used for a painting to be placed in the school library and the balance to be donated to Nathan Adelson Hospice in her memory. Please accept the attached check for $459.88 from our school for this purpose. We all appreciate what the hospice did for Mrs. Lamb to make her final days more comfortable." The letter was signed by Norman Parker, Principal of Gene Ward Elementary School. HOSPICE NURSE Debbie Martin, R.N. acted quickly and saved SAVES A a life. She applied the Heimlich maneuver to LIFE Leona Brockway, wife of hospice patient Gordon Brockway, on September 3, 19 86. Food had become lodged in Mrs. Brockway's throat while she was having dinner with her husband in his room. She was unable to breathe, and in fact, had begun to turn blue when Martin arrived. Martin immediately and successfully applied the Heimlich maneuver. We're all proud of Debbie's heroic action. This is the third time during the two years I've been the Executive Administrator that I've written letters of commendation to facility personnel who have clearly saved the lives of visitors. It's an honor to work with so many wonderfully skilled and attentive professionals We offer many in-service training sessions for hospice personnel - in fact, on September 29th, we are offering another CPR training class. PRE-COLUMBIAN ART AND ANTIQUES One of our nurses has a collection of art and antiques. She has approached me with the suggestion that we consider an auction. Auction or not, her collection includes 18 Central and South American pieces that are "certified and appraised". Our nurse also has Byzantine and Roman pottery and Venetian glass. If anyone is interested, or knows a collector who might be, please give me a call. 50% of any sale will go to the hospice. NAHF SIGNAGE Don't forget our signs as you consider promoting PROGRAM events and activities. The NAHF gets 40% off the top on these mobile beauties. The signage program generated over $19,000 last year and we didn't push it at all. Brochures are available - call Tom @733-0320. UNITED WAY We are participating in the United Way campaign IS again this year. This will be the third year UNDERWAY they have donated $10,000 to our program. Foundation Director Tom Kenefick has been asked to serve on the newly formed Publicity Council for United Way agencies. The initial goals of this council will be to strengthen the relationship and communication between the United Way and its agencies and to create a greater community awareness of the individual agencies as they relate to United Way. NOVEMBER is NATIONAL HOSPICE MONTH As part of our celebration of National Hospice month, the staff and volunteers of NAH are now making plans to conduct a lovely candlelight service in memory of the more than 1,400 hospice patients who have ended life's journey in our program. We are considering a service in the central patio. Any trustees interested in helping, in planning, lighting candles, getting media coverage, etc. Please call! CANCER Sedentary male workers may be twice as likely FACTS to develop colon cancer as their more active colleagues. An S.U.N.Y. study suggests that-physical activity diminishes the time that waste remains in the digestive tract. The theory is that exercise could speed carcinogens past the colon and explain the low rate of rectal cancer among men who are physically active . . . you don't have to own jogging shoes, walking shoes will work if you get up and use them. The American Cancer Society predicts that 123,000 American women will be diagnosed this year as having breast cancer, and nearly 40,000 will die. It's believed that as many as 7,500 of those lives could be saved if every woman 40 or older had an annual mammogram. "It is vital to find the tumor when it is smaller than a pea", warns Dr. A. Christine Watt, Director of breast imaging at Henry Ford Hospital in Detroit. "This is, perhaps, five or six years before it has grown to the far more dangerous lump and mammography is the most accurate method of discovering tumors." CANCER FACTS (CONT.) An article published in the May 8th edition of the New England Journal of Medicine called the war on cancer an "unqualified failure". Since 1950 the report says that billions have been spent on research but the number of people who died of the disease actually increased! I'm not reporting this because I think that contributions for cancer research should go elsewhere, on the contrary, we cannot afford to stop funding research . . . but these figures also point out the ever increasing need for quality hospice care. In 1950 there were only 170 cancer deaths per 100,000 Americans, in 1982 for every 100,000 we lost 185 - an 8.7% increase. According to the ACS, 30% of Americans now living will eventually have cancer. Over the years cancer will strike in approximately three out of four families. Of those diagnosed with cancer this year about 6 out of 10 will not be alive 5 years from now. This year about 1,293 people a day, about one every 67 seconds, will die of cancer. Stop smoking. Lung cancer leads the cancer morbidity tables by nearly 4 to 1 over the runner-up (prostate cancer). Smoking related cancer is preventable. A THOUGHT ABOUT OUR KIDS AND THEIR KIDS You and I have a marvelous hospice program here . . . it is helping us, our families and our friends now . . . today . . . but look at the statistics. Our children and our grandchildren are going to need hospice too. Please do what I've done - make the hospice part of your estate planning. We have the opportunity to leave a legacy of love, security, dignity and peace. Our kids deserve a shoulder to lean on. MEDICARE AUDIT Congratulations to the hardworking hospice staff SMOOTHEST EVER on their virtually spotless Medicare audit concluded last week. Gloria DeHart, Patient Care Coordinator; Linda Levine, In-Patient Head Nurse; Cindy Compton, Infection Control Practitioner; and Marianne Davidson, Personnel Director had never been through the microscopic exam Medicare administers. Some of our staff; Estelle Neal, Consulting Dietician; Judy Harrington, Social Services Director; Janis Dionne, Medical Records Director; and Leroy Gamble, Physical Plant Manager were old hands. How thorough are the auditors? "I found a few crumbs in the kitchen mixing bowl, not enough to cite you, but don't let it happen again." Sherlock Holmes would have been impressed! WORLD'S FINEST HOSPICE PROGRAM We toot our own horn about the prominence of NAH in the American Hospice Movement and about the quality of our care. We do so with good reason . . . according to the National Hospice Organization there are now 1,568 hospices in the country and none match our resources. However, with the addition of a single component we could be unquestionably the best. We do not have our own nursing facility . . . in fact, because the state of Nevada uses an archaic formula to determine how many nursing home beds an area needs (state Certificates of Need are required for construction or expansion) we have a chronic nursing home bed shortage! The world's finest hospice program would look like this: HOME CARE ACUTE CARE NURSING HOME CARE As you can see, the NAH has three of the four components required to complete the perfect hospice program model. All three components (home care, acute care, foundation) are also solidly developed and universally recognized as second to none. With the establishment of our own skilled nursing facility or the designated availability of ten or so beds in an existing facility (furnished and staffed with the hospice concept in mind) we would have a complete and balanced program. A terminal patient could enter our "loop" of care and the patient and family could be moved to the most appropriate setting as his/her medical needs change . . . without losing the important continuity of care (same philosophy, nurse, volunteer, physician, etc.) that is essential for the success of hospice's total family involvement. The existence of a non-acute hospice facility would also allow a much finer level of fiscal management because as soon as a patient's acute symptoms are controlled, and most can be in 7-9 days, the patient can be discharged to a more medically appropriate and less costly facility. An NAH skilled nursing facility . . . it would make us unquestionably the world's finest . . . and it would preserve private funds. I'd like to talk about this with every trustee. ISSUE NO. 4, SEPTEMBER 1986 TELEPHONE: 733-0320 The Nathan Adelson Hospice "A NOT FOR PROFIT COMMUNITY ORGANIZATION" BOARD OF TRUSTEES Merv Adelson Co-Chairman Pearl Adelson Co-Chairman Irwin Molasky Co-Chairman Renny Ashleman Donald H. Baepler Jerome G. Blankinship A1 Benedict Eli Boyer David Brandsness Sharon Brandsness Monterey Brookman Irwin Buchalter Anthony Carter, M.D. Don Digilio Thalia Dondero Lovee DuBoef Harold Erickson Hank Greenspun Mel Hecht Charles Kilduff, M.D. Jerry Kring Samuel Lionel Ron Lurie Jerome Mack Marydean Martin Mary Ann Michel Susan Molasky Mike O'Callaghan Owen Peck, M.D. Lee Rich Allard Roen Willis Russell, M.D. Arthur Sandoval Art Smith William K. Stephan, M.D. Muriel Stevens E. Parry Thomas Richard Thomas David Zenoff MEMORANDUM September 23, 1986 TO: NATHAN ADELSON HOSPICE & FOUNDATION TRUSTEES FROM: BUCK DEADRICH, EXECUTIVE ADMINISTRATOR Welcome back. The Nathan Adelson Hospice program has been very active during the summer months. I hope you've been reading my June, July and August Trustee Letters. This issue is really packed with information. Short one or two page letters are easier for you to read and easier for me to write, but a trustee's effectiveness is tied directly to his or her knowledge. Certainly it's true that you are busy people, so some of you may not be able to find the time to read everything I'm sending you, but the busiest people are the best people and it's part of my job to put as much meaningful information in front of you as possible. So here is everything you always wanted to know about the hospice and more. I hope you'll read most of it. The guality of our terminal care is directly tied to your support, leadership and stewardship. We are the quintessential community based program. We serve only our community and we are funded by our community. Please come in and see how we're doing. P.S. The center of this Trustee Letter is a directory that is designed to slip out so you can keep it handy as a ready reference. It includes all of your fellow trustees updated phone numbers, our mission statements and excerpts from some "orchid letters" we have received from family members. BD:1lr cc 4141 S. Swenson Street ? Las Vegas, Nevada 89119 ? (702) 733-0320 Nathan Adelson Hospice & Foundation TRUSTEE DIRECTORY NATHAN ADELSON HOSPICE MISSION STATEMENT To provide America's finest: hospice in-patient and home care to every medically appropriate patient with a six month terminal diagnosis, without regard to his or her ability to pay. Hospice care is palliative, focusing on patient comfort and family support when cure is no longer possible. The hospice provides 24 hour centrally administered physical, social and spiritual assistance for dying patients and their families. The Nathan Adelson Hospice non-profit program uses its interdisciplinary teams; physician, nurse, social worker, counselor, clergy, aide and volunteer to help the patient achieve a pain free, dignified close to life's journey. We also care for the patients, family and friends through our bereavement program, both before and after the patient is gone. NATHAN ADELSON HOSPICE FOUNDATION MISSION STATEMENT To provide the private funding and public awareness necessary to guarantee that the Nathan Adelson Hospice has and will always have the financial and community resources it needs to fulfill its important mission. The Nathan Adelson Hospice Foundation also recognizes the importance of firmly establishing hospice philosophy and care as part of American medical practice. To accomplish this, the Nathan Adelson Hospice Foundation supports the National Hospice Organization, the development of hospice programs and hospice awareness throughout the country. "Birth and death are the most singular events we experience and the contemplation of death as birth should be a thing of beauty. Hospice is helping to make it so." - New York Senator Jacob Javits 1904 - 1986 NATHAN ADELSON HOSPICE TRUSTEES CO?CHAIRPEOPLE Merv Adelson Pearl Adelson Irwin Molasky 213-202-2254 735-0155 BOARD MEMBERS Renny Ashelman Donald Baepler Jerome Blankinship A1 Benedict Eli Boyer David Brandsness Sharon Brandsness Monterey Brookman Irwin Buchalter Anthony Carter, M.D. Don Digilio Thalia Dondero Lovee DuBoef Harold Erickson Hank Greenspun Mel Hecht Charles Kilduff, M.D. Jerry Kring Samuel Lionel Ron Lurie Jerome Mack Marydean Martin Mary Ann Michel Susan Molasky Mike 01Callaghan Owen Peck, M.D. Allard Roen Willis Russell, M.D. Arthur Sandoval 1-786- 739- 731- 731- 213-381- 1-356- 1-356- 386- 213-626- 383- 385- 383- 870- 739- 385- 645- 735- 737- 385- 383- 386- 382- 739- 732- 385- 1-784- 619-438- 876- 871- 4048 3381 8000 0200 5393 8207 8204 3044 6700 8640 ?3111 3500 1695 3286 ?3111 ?6624 ?2434 ?7211 ?2188 ?3500 ?1217 ?4003 ?3693 ?4136 ?3111 ?6007 ?9111 ?5879 ?3133 Art Smith William Stephan, M.D. Muriel Stevens E. Parry Thomas Richard Thomas David Zenoff 1-784-3000 735-3200 383-7146 386-1000 385-0995 619-438-9111 ACTIVE HOSPICE COMMITTEES Executive Committee Finance & Planning Committee Joint Conference Committee Nominating Committee Buck Deadrich Executive Administrator Hospice - 733-0320 Home - 456-6545 NATHAN ADELSON HOSPICE FOUNDATION TRUSTEES OFFICERS Alvin Benedict - President 731-0200 Ray Norvell - Vice President 735-9141 Susan Molasky - Treasurer 732-4136 Jan Jones - Secretary 733-9445- BOARD MEMBERS Al Benedict Merv Adelson Pearl Adelson Donald Baepler Eli Boyer David Brandsness Sharon Brandsness Steven Cohen Bill DeAngelis Joseph Delaney Ruthe Deskin Beth Dias Thalia Dondero Lovee DuBoef Margaret Elardi Donna Epstein Joseph Esposito Lola Falana Elias Ghanem, M.D. Jody Ghanem Brian Greenspun Hank Greenspun Dema Guinn Clair Haycock John Hayes Jeanne Hood Nancy Houssels Dorothy Huffey Theodore Jacobs, M.D, Earl Johnson Jan Jones Jeffrey Kahn Herb Kaufman Autumn Keyes Jerry Kring Fred Lewis Ernest Libman Samuel Lionel Jerome Mack 731-?0200 Marydean Martin 382- 4003 213 -202-?2254 Herb McDonald 731-?2115 Phyllis McGuire 878- 5039 739- 3381 Barbara Molasky 369- 8662 213 -381-5393 Irwin Molasky 735- 0155 1 -356- 8207 Susan Molasky 732- 4136 1 -356-8204 Elaine Newton 382- 2111 Ray Norvell 735- 9141 739- 4611 Francine Pulliam 382- 0700 384- 5378 Lee Rich 213-?281-4002 383- 7209 Allard Roen 619-?438-9111 453- 1077 James Rogers 649- 0500 383- 3500 Sig Rogich 362- 6900 870- 1695 Donald Romeo, M.D. 384- 8533 1 -298-2442 Bernard Segelin 451- 1016 735- 4369 as of 10-1-86 213- 476- 4696 739- 4860 Maynard Sloate 737- 2111 451- 7114 Steven Smith 876- 1313 731- 6060 Muriel Stevens 383- 7146 731- 6060 Pam Wald 451- 2212 385- 3111 Denny Weddle 733- 0123 385- 3111 Lynn Wiesner 870-1480 362--5555 Elaine Wynn 386- 8334 382- 1620 David Zenoff 619- 438- 9111 367-?3525 385- 4011 ACTIVE FOUNDATION COMMITTEES 878- 4342 458- 1883 Annual Giving Committee 735- 0258 Events Committee 383- 0237 Executive Committee 870-?9444 Finance Committee 818' -981-5400 Grants Committee 735--3191 Marketing Committee 643--6060 Planned Giving Committee 737--7211 Public Relations Committee 731-?1300 Southern California Chapter 386--4908 385--2188 Buck Deadrich 386--1217 Executive Director Foundation - 733-0320 Home - 456-6545 ORCHID LETTERS " . . . when my father's condition worsened, I contacted Kathy. From that day on, Kathy and Joanna visited my father at home regularly where they took care of his medical needs with the highest dedication in addition to helping my mother with his day to day care. I cannot find the appropriate words to express my deepest feelings of appreciation . . . " " . . . Mom was in Quad B and during that time all of you that helped her were so knowledgeable of her every need. Thank you. You made her comfortable and went along with us when we asked for sometimes unreasonable requests. You never seemed to tire and always came with a smile and a helping hand. God bless you - each and every one for this . . . " " . . . Thank you for all you've done and did during the illness of my mother. Even though she was not a patient in your facility, your encouragement and help really did me good. I never would have been able to cope or care for her at home without the home visits and counseling that was provided by your staff and volunteers. Thank you again . . . "