Ochsner pressured 8 COVID-19 patients to accept hospice care, families say

Many hospitals in New Orleans sent older COVID-19 patients home to die amid a surge in cases this spring, with some families claiming employees pressured them into accepting hospice care, according to an investigative report from ProPublica

The nonprofit newsroom analyzed coroner records of more than 460 COVID-19 deaths that occurred in New Orleans through early May. Fifty-five deaths occurred outside a hospital, nursing home or assisted living facility. ProPublica spoke to the families of 35 such patients who died at home.

Twenty-five families said their loved ones died after seeking care at hospitals in the city. While some patients were told they were not sick enough to be admitted, 18 patients were hospitalized and then sent home to die under hospice care, families said. Most of these patients came from facilities affiliated with New Orleans-based Ochsner Health, which treated 60 percent of the region's critically ill COVID-19 patients, according to ProPublica

Eight families claim Ochsner employees pressured them into accepting hospice care for their loved ones, and three said employees told them there wasn't enough space to continue treating the patient at the hospital. Families say they were forced to care for their loved ones without adequate personal protective equipment or regular visits from hospice workers, who limited in-person interactions this spring. 

Mortality data shows 17 percent of patients ages 85 and older died at home in New Orleans, compared to just 4 percent nationwide. 

CMO Robert Hart, MD, said Ochsner did move patients around the system due to bed space this spring, but never rationed care. 

"We did fine managing patient flow and had available beds for patients," he told Becker's

While some of Ochsner's routine hospice agencies said they could not take COVID-19 patients during the surge, Dr. Hart said the system proactively worked to identify the ones that met CMS requirements and were adequately equipped to take COVID-19 patients.

"Our team is very experienced at having conversations about palliative care and hospice with families, and we do everything we can to ensure there is a comfortable hand off and transition into hospice," he said.

When asked about families' claims that they felt pressured into hospice care, Dr. Hart said families were at times taken by surprise with how quickly patients decompensated. 

"It can take families time to process this information," Dr. Hart said, adding that visitor restrictions, the anxiety around COVID-19 and the need to make difficult decisions took a toll on both clinicians and family members.

"This has been a difficult time for everyone," he said. "A lot of people have lost loved ones. That's always a terrible thing for families and caregivers to deal with. I am proud of how our group has stepped up to deliver incredible care in such trying times."

More articles on public health:
US coronavirus death rates by state: Aug. 21
Number of COVID-19 hospitalizations, state by state: Aug. 21
20 states where COVID-19 is spreading fastest, slowest: Aug. 21

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