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San Diego Hospice Sees More Layoffs, Hospital Closure


San Diego's largest hospice operator temporarily shut down its 24-bed hospital in Hillcrest and laid off more staff Monday, as it struggles with an on-going Medicare audit.

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.

The hospital is an "extraordinarily expensive facility," according to San Diego Hospice President and CEO Kathleen Pacurar.


The closure and layoffs came in anticipation of the hospice provider having to pay back millions of dollars in benefits once the audit is complete, Pacurar said.

The audit, which began nearly two years ago, is looking at whether thousands of people who used San Diego Hospice were actually eligible and whether their medical diagnoses were properly documented.

Hospice is a type of care for people who are determined to have less than six months to live. It provides pain management and treatment of symptoms rather than curative care; things such as chemotherapy or surgery.

Medicare pays for most hospice care and the cost across the country is growing, ballooning from $2.2 billion in 1998 to $12.1 billion in 2009, according to government statistics.

Medicare Hospice Benefit
Official government booklet on who is eligible for the hospice benefit under Medicare.
To view PDF files, download Acrobat Reader.

As a result of the growing cost of hospice, Medicare has been investigating the use of the benefit.

San Diego Hospice got notice of its audit in February 2011. Within days, eight people descended upon the facility and examined records for five days, Pacurar said. And the provider is now required to submit all paperwork on every patient it admits into care. But Medicare has yet to issue a final report.

“At this point, we still don’t have any information on the audit still,” Pacurar said.

To date, San Diego Hospice has laid off 280 employees, about a third of its staff, and reduced the number of patients from 1,000 to less than 700. Pacurar said she hopes to re-open the Hillcrest facility as a less expensive treatment center, rather than an acute-care hospital.