Abstract
Health care organizations across America face an uncertain future. Hospice organizations are no different. There is uncertainty in future revenue sources, staffing, future patient and family demographics, community resources, and, most of all, uncertainty in government regulation of hospice services. Dwelling on this uncertainty can be unsettling, even for a stable, forward-thinking end-of-life care provider. As chief executive officer (CEO) of Four Seasons in Flat Rock, North Carolina, this author is always thinking about how “the unknowns” will affect the 700 patients per day who are provided with hospice and palliative care services in Western North Carolina. Four Seasons is the top hospice provider in North Carolina, serving more than 63% of the deaths in our home county, as determined by its death service ratio. For information about deaths served by hospices in North Carolina by county, see Table I.
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