A Message from Edo Banach

To:   NHPCO Membership
Date:     September 3, 2020

There is no question that the COVID-19 pandemic has challenged every sector of the U.S. health care delivery system; health care providers have been overwhelmed by this unprecedented public health emergency, and hospice care is no different.

An article published yesterday by ProPublica, “Sent Home to Die,” raises many concerns and paints a tragic picture of multiple health care delivery system failures, prompted by COVID-19.  I felt it appropriate to share some thoughts with you, the NHPCO membership. (Note: ProPublica is an independent, non-profit news site that produces investigative journalism that is shared with other online, print, and broadcast news services.)

NHPCO stresses that the choice of whether to access the person-centered, interdisciplinary care that hospice brings to people with a life expectancy of less than six months must always rest with the individual at the center of care. While we as a provider community would never want people to be influenced to forego hospice, patients should never be forced into accepting hospice care by those in the medical community. An individual’s rights to choose the care they want when facing a medical crisis should never be lost, especially during a pandemic.

All hospice providers must be committed to delivering the highest-quality, person-and family-centered care that not only meets but exceeds federal guidelines. It is our job as providers to ensure that all the individuals that elect hospice are eligible and receive care in a timely manner. I would also remind providers that standard practice dictates that you do not accept a patient if it is beyond your capacity to provide necessary and appropriate care for them. This is nothing new, this is clearly outlined in the Medicare Hospice Conditions of Participation.

The COVID-19 pandemic has underscored the long-standing racial disparities in health and health care. NHPCO is working to address issues of health equity. Last month, the NHPCO Diversity Advisory Council released a position paper, COVID-19 and Supporting Black Communities at the End of Life. COVID-19 deaths to date have disproportionally impacted Black people and other people of color. This position paper discusses why Black people have been disproportionately affected by COVID-19 and emphasizes the need to build trust with diverse populations while we acknowledge the pain, misery, and grief caused by this horrible virus.

I understand the pressure that so many of you are facing. Among the many issues brought about by COVID-19, hospices have faced a continuing lack of personal protective equipment. Despite being challenged by access to tests, supplies, and support, hospice providers have innovated their delivery of care to adapt to this new world.

As the primary provider of community-based, person-centered care, hospices continue to be a safety net for those who struggle to access institutional, medical care. For your commitment to this care, I thank you.


Edo Banach, JD
President and CEO

Note:  As a reminder, NHPCO has created COVID-19 resources for providers available at www.nhpco.org/coronavirus.