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When Does End Of Life Begin?

LC Sallis shares a laugh with his doctor, Daniel Hoefer, at his home on Jan. ...

LC Sallis shares a laugh with his doctor, Daniel Hoefer, at his home on Jan. 10, 2013. LC is in stage four heart failure, and has opted to spend his remaining days in hospice care.

About The Series

Everyone is familiar with the high-profile and politically charged question, “When does life begin?” But as our friends and family members live longer and survive what once were commonly fatal ailments, another question takes center stage. When does end-of-life begin?

It may carry just as much emotional and political baggage.

The KPBS and I-Newsource Investigations Desk is embarking on a months-long examination of that question medically, financially, politically -- and just as importantly -- personally.

San Diego is ground zero for this inquiry because San Diego Hospice, California’s largest hospice provider and a pioneer in the field, has been discharging patients, laying off workers and cutting back on expenses as the federal government breathes down its neck. Medicare has been auditing San Diego Hospice for two years, and the results could mean the hospice must reimburse the government millions of dollars in payments found to be ineligible for coverage.

What does this mean for you and for your loved ones who are in fragile health?

Through 2013, we will be answering that question through our intensive reporting and with your help. We want to hear your feedback and your stories at

Hospice Under Scrutiny

Choosing Life Or A Better Death: Hospice Under Scrutiny

Dying patients are faced with a difficult choice: a comfortable death or expensive medical treatment that might make them feel better and live a little longer.

Adam And Krystyna: Hospice Under Scrutiny

San Diego Hospice kept Krystyna Saling in care for six years, and then discharged her in November. She has end stage Alzheimer's.

When Does End Of Life Begin: Hospice Under Scrutiny

With a growing number of people choosing to die at home, the federal government is questioning who's in hospice and for how long.

Truce Declared In San Diego Hospice Bankruptcy Battle

Attorneys agree to work together to sell San Diego Hospice's Hillcrest property to pay creditors.

Drama Unfolds In San Diego Hospice Bankruptcy

A judge is supposed to decide today, whether to appoint a special trustee to oversee what's left of San Diego Hospice.

Medicare Stakes Its Multimillion-Dollar Claim In Hospice Bankruptcy

Court documents reveal, San Diego Hospice owes Medicare millions. And it wants a trustee to take over what's left of the organization.

Inspectors Visited San Diego Hospice At Least 15 Times In Two Years

Inewsource creates timeline of San Diego Hospice patient care inspections.

Serious Questions About Patient Care At San Diego Hospice

This is the first indication patient care was an issue for the beleaguered San Diego Hospice, not just money.

San Diego Hospice Cared for Hundreds Of Ineligible Patients

A chief executive with San Diego Hospice testified in bankruptcy proceedings this week, the organization discharged as many as half its patients because they were not eligible for care.

San Diego Hospice Failed To Report Patient Data To State

The troubled San Diego Hospice did not report patient information to the state back in 2009 and 2010 - information that would have indicated how long hospice patients received care.

San Diego Hospice Needs $2 Million To Care For Dying Patients

San Diego Hospice continues to care for 401 dying patients - despite being in bankruptcy court and winding down operations for good. But the care of those patients could be in jeopardy if the organization does not get an immediate two million dollar loan.

Fired Nurse Files Lawsuit Against San Diego Hospice

In the lawsuit, a former nurse for San Diego Hospice alleges executives encouraged employees to falsify records and admit patients, even if they didn't need care.

'It Was A Beautiful Ending To A Beautiful Life'

A sad update on a story about a San Diego man profiled in our end of life series. LC Sallis, 89, died Sunday evening with his wife Betty by his side.

Medicare Audit Forces San Diego Hospice To Close

The largest hospice provider in California, San Diego Hospice, announced it will cease operations in the midst of a lengthy federal audit.

Scripps Health To Begin Offering Hospice After San Diego Hospice Cutbacks

Scripps Health announced today that it will begin offering hospice services in the wake of San Diego Hospice's recent cutbacks and decision to file for Chapter 11 bankruptcy protection.

San Diego Hospice Files Chapter 11 Bankruptcy

Chapter 11 will allow the hospice provider to reorganize and stay in business. The move follows a two year federal investigation into patient eligibility.

San Diego Hospice Moving Operations

The county's largest hospice provider is moving to its Hillcrest facility to save money.

San Diego Hospice Sees More Layoffs, Hospital Closure

In an effort to save money, the county's largest hospice provider closed its 24-bed hospital in Hillcrest and laid off more staff.

San Diego Hospice Lays Off Staff, Cuts Services

Financial pressures have forced San Diego's oldest and largest hospice to cut staff and services.

San Diego Hospice May Have To Cut 200 Workers

The largest hospice program in San Diego County may lay off hundreds of employees to cope with financial problems because it may have violated Medicare regulations.

How Mom’s Death Changed My Thinking About End-of-Life Care

My father, sister and I sat in the near-empty Chinese restaurant, picking at our plates, unable to avoid the question that we'd gathered to discuss: When was it time to let Mom die?