Practice Spotlight: Nathan Adelson Hospice

Nathan Adelson Hospice

Angela Collins, RN, MBA – Chief Operating Officer
https://www.nah.org/

Background

As Southern Nevada’s largest and only nonprofit hospice/community-based palliative care organization, Nathan Adelson Hospice (NAH) has been providing advanced illness care, including home-based primary care services, for more than 42 years. A member of the National Partnership for Healthcare and Hospice Innovation, NAH is dedicated to ensuring patients and their families have access to care that reflects their individual goals, values, and preferences.

HCCInform: How would you describe your staffing model?    

Collins: NAH employs physicians, advanced practice registered nurses (APRNs), registered nurses, social workers, spiritual care professionals, licensed practical nurses, certified nursing assistants, volunteers, and bereavement counselors to deliver an integrated, holistic approach to healthcare, no matter where a person resides. And under the NAH umbrella, our Trusted Primary Care program is an APRN-driven home-care model with physician oversight and support from the entire organization.

HCCInform: What are some recent challenges your practice has faced?    

Collins: Like so many others, COVID has been a challenge for us. We had many patients and families who wanted care and were concerned about having people in their homes, especially early in the pandemic. That has started to abate as more people are vaccinated, and we’re starting to see increased volume.

With that said, many of our patients are sicker than ever before. From our perspective, there was a gap in care in 2020 caused by the pandemic, and perhaps some of the disease processes weren’t managed as well as they might have been pre-pandemic. We managed well with telehealth, but it doesn’t fully replace hands-on care.

As we push through COVID, we’re seeing greater acceptance of in-person visits and catching up with the lack of care some patients experienced. We’re growing by leaps and bounds, and the workforce shortage presents challenges. Competition is fierce for attracting and retaining the quality of clinicians we require to serve our patients. There are daily ups and downs regarding disease processes, increased utilization, etc., but it really comes down to managing the volume of the patients who request services with the staff we have available to assist them, while maintaining the high quality of care standards NAH is known for.

HCCInform: What makes you especially proud of your practice?    

Collins: We’re proud of what we’re doing in our community not just as a hospice, which is our overarching organization, but for all our entities within NAH. For our house call and primary care patients, we have palliative care if they need it, and we have hospice should the need arise. NAH brings a full range of support to these patients and their families in their homes, and we work diligently to keep these patients at home, which is where most people want to be.

NAH is also proud to be part of Advanced Illness Partners, a direct contracting entity (DCE) comprised of seven nonprofit organizations who, together, care for more than 60,000 patients annually. We’ve taken responsibility for supporting and managing some of the highest risk patients in our community, which is a tall order. These individuals are very sick – it’s almost like Hospital at Home in many cases – and NAH has been very successful in bringing this wider scope of services to our Las Vegas valley and Pahrump-area residents.

This year NAH was named one of the best places to work by Modern Healthcare for the 10th time, which is unprecedented for any organization – and for an organization our size, it’s amazing. We earned this honor, in part, based on high employee engagement scores, which we maintained despite the challenges brought about by the pandemic.

NAH also achieved Level Five in the National Hospice and Palliative Care Organization’s We Honor Veterans program. This designation recognizes our efforts to increase access to hospice and palliative care for veterans in our community and ensure they receive the specialized services they need. Finally, we’re the only organization in our area to have received accreditation by The National Institute for Jewish Hospice.

HCCInform: What are some goals your practice is focusing on right now?  

Collins: Our biggest goal is expanding our footprint and the care that we can provide through our primary care program to Southern Nevada residents. We are also adding another provider so that we can care for more individuals. We’ll also continue partnering with the community, working closely with our area hospital systems, managed care groups, and others.

HCCInform: Is there anything else that you want to share with us about your practice?  

Collins: We’re always looking for new ways to serve our community and neighbors. That’s why we have been moving into initiatives like home care, the DCE program, and Advanced Cardiac Care program – trying to find better ways to care for patients and families. When opportunities like these arise, we put our resources behind them as we see how they will benefit patients, their families, and our community.

Our vision statement is, “No one ends the journey of life alone, afraid, or in pain.” That drives everyone on our team to always find new ways to serve our patients and provide a higher level of care. Entering the home-based primary care space is one example of our commitment to bringing more innovative, effective models of care into Southern Nevada.

We’ve also been fortunate to collaborate with HCCI’s team for several years, and its services have benefited us in several areas, including providing personalized training for our APRNs and chart audits/assessments providing guidance and insight for improving our billing practices.

HCCInform: Why do you love house calls?   

Collins: I love house calls because they’re an important part of how we care for our neighbors. Las Vegas is a big city, but it’s very much a small town at the same time. Pretty much everybody knows everybody. Having house calls as a service offering, as part of NAH as a larger entity, enables us to touch people further upline. With our house call program, we can help people sooner and provide the level of service they need, right in their homes. Also, NAH serves some rural communities, and we staff from those communities, which is important — neighbors caring for neighbors.

Nathan Adelson Hospice: Stats At-a-Glance

Practice Setting: Hospice/community-based palliative care organization with HBPC

Types of Services Provided: Longitudinal HBPC, advance care planning, palliative/hospice care

Active patient census, including all providers

• HBPC: 200 +
• Inpatient palliative: 80-90 daily

Average daily home visits by all providers: 7-9