Weird Feelings About Volunteering at a For-Profit Hospice
October 13, 2018 7:29 AM   Subscribe

So I'm looking into volunteering at a hospice. I met the coordinator, she's seems great. The program seems great. One thing that's been bothering me though...this is a for-profit hospice. Am I being overly nitpicky about where I volunteer?

The non-profit/for-profit question wasn't much of an issue until I began learning more about hospices, and learning that there ARE non-profit and for-profit models. Apparently for-profit hospices are required by law to have a percentage of volunteers (I have no idea why). I was reading an article about the allegations against one of these for-profits (millions of bucks going to the top officers). These for-profits make money through Medicare.

Of course, I'm not saying the organization I applied to is unscrupulous in any way. (And again, the coordinator seemed great.) But the idea that I'm volunteering for free for a profit-based organization does not sit well with me. I'm uneasy with the fact for-profit hospice organizations are hiring volunteers and not paying them (I know it's required by law, but still....) I am thinking I might just want to drop out of this program before I start any training, and go volunteer my services at a non-profit hospice instead.

Am I splitting hairs here and my qualms overblown? Could anyone whose worked for either a non-profit or for-profit hospice clue me in? Thank you!
posted by neeta to Grab Bag (6 answers total) 2 users marked this as a favorite
You shouldn't volunteer somewhere that you feel ethically questionable about. I would find a different place to volunteer, even if the coordinator seems nice. The way to hell is paved with good intentions.
posted by sockermom at 7:38 AM on October 13, 2018 [13 favorites]

"Apparently for-profit hospices are required by law to have a percentage of volunteers (I have no idea why). "

If it matters, the rules date to when hospice was a brand-new thing Medicare was paying for in the early 80s, and basically all of them were non-profits run by religious organizations. Medicare was trying to sort out what a hospice was and what it did, and the ones that were legitimate at that time were run by community religious groups trying to give people kinder deaths. Obviously hospice has become very mainstream in the nearly 40 years since then, and the medical landscape has changed a lot.

So, the justification for maintaining the requirement now that there are many for-profit hospices is that they're still meant to be rooted in the community, and using community volunteers helps do that. I think you can be comfortable in that hospice is pretty strictly regulated and the volunteer rules are pretty extensive and have protections against using volunteers to replace or push out paid staff, and restrict what kinds of things volunteers can do -- you SHOULD be doing the kinds of things neighbors would do for each other in a touchy-feely Hallmark movie, building that community connection. (There are pretty extensive rules dealing with a lot of edge cases and I will assume your hospice knows them inside and out, so every now and then you're like "huh, this doesn't seem community-connective" but then you go read the Medicare guidance on the issue and you're like, "oh, right, that makes sense, I see how they got from that core function to this particular edge case.")

Regarding your specific for-profit, a quick google should pull up whether your hospice is falling afoul of the Medicare rules, and your state medical regulatory board should also have some information available.

I can't tell you whether you should volunteer for a for-profit organization, but hospice is one of the few areas in which that's quite normal, and highly regulated to avoid hinkiness or exploitation of volunteers or use of volunteers to push out staff.
posted by Eyebrows McGee at 7:56 AM on October 13, 2018 [28 favorites]

If you think that volunteering at a not-for-profit means you can be sure of avoiding this issue, your understanding of what not for profit means would benefit from a bit of additional research. Non-profit doesn't mean an org can't make any money; it means that the money they make is tax exempt. Non-profits can and absolutely do make profits, often huge profits, often used in ways donors would be unhappy about it they were aware of them.

The CEO of United Way takes home over a million bucks a year. In healthcare, which hospice falls under, this is typical for CEO salaraies at non-profits.

You should judge organisations individually based on their numbers, not on their tax exempt status. Ask for an annual report of any organisation you're considering volunteering with.
posted by DarlingBri at 8:31 AM on October 13, 2018 [17 favorites]

I think for the people there, it really doesn't matter... No matter where you serve the individuals are in similar medical condition and need the same sort of volunteer service. It's about providing compassion to those who are at the end of their lives.

If you can do that and want to do that it's fine.

For any medicare facility there is a reporting process if you witness abuse, neglect or explotation. Please use it if you need to. In my state it's reported to the department of public health.

The service your providing isn't a billable service under medicaid or medicare which is why there isn't paid staff to do it, and it also takes time, and effort. A volunteer who can just sit with someone and has no other tasks is invaluable. None of the nurses or cnas or therapists have that much free structure in their schedules.

It's also something that most people can do, it just requires compassion and the ability to connect with others respectfully.
posted by AlexiaSky at 9:52 AM on October 13, 2018 [9 favorites]

I'm a hospice volunteer. I get a lot more out of it than the organization gets out of me. That is, I do it for me and the patients.
posted by andreap at 2:22 AM on October 14, 2018 [2 favorites]

I think the day to day experience matters a lot more. These are people’s deaths we’re talking about and providing them a graceful exit is, one hopes, the goal. Seen in that light, your presence and influence may be more important in borderline organizations, for-profit or not.
posted by Tell Me No Lies at 6:14 PM on October 14, 2018 [1 favorite]

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