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Hospice programs provide comfort care for dying patients in their own homes, nursing homes, hospitals or other care centers. Hospice staff may include doctors, nurses, social workers and home health aides.

Medicare patients comprise 84 percent of hospice patients nationwide.

The authors note there’s been a surge in for-profit hospices _ from 725 to 1,660 between 2000 and 2007. Nonprofit hospices remained mostly stable during that time, numbering 1,205 in 2007, the study said.

Two of the nation’s largest for-profit hospice groups, Miami-based VITAS Innovative Hospice Care and Gentiva Health Services, Inc. in Atlanta, declined to comment on the study.

But a Gentiva spokesman said it doesn’t discriminate on the basis of diagnosis, ability to pay “or any other criteria.”

Dorothy Deremo, CEO of Hospice of Michigan, one of the nation’s largest nonprofit hospice programs, said the study “just confirms what exists” in the hospice industry. For-profit hospice programs “are selectively marketing to those physicians and facilities that will give them the portfolio of patients that will create the highest profit.”

While the study lacked data on type of care provided, it found that patient visits from hospice nurses averaged less than once daily in both for-profit and nonprofit hospices. Wachterman said there’s a common misconception that hospice workers provide round-the-clock bedside care. Instead, hospice workers typically provide more intermittent care but counsel family members and other caregivers on how to provide “moment to moment” care, and are available 24 hours a day if problems arise, she said.

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Online:

JAMA: http://jama.ama-assn.org

National Hospice and Palliative Care Organization: http://www.nhpco.org.