Today’s Southern Voices submission comes to us from a team of caregivers at Nashville’s Alive Hospice — Jessica Blagys FNP, DNP; Torie Nims BSN, RN; Heather Wills BSN, RN, FCN; and Teresa Yarbrourgh BSN, RN, LPC. They’re asking for the community’s support as they fight to maintain their not-for-profit status, so they can help support our community members when they need it most.
Fifty years ago, Dr. and Mrs. David Barton and Dr. John Flexner, along with a host of committed community leaders, saw their boldest dreams become a reality when Alive Hospice opened its doors as Middle Tennessee’s first and only nonprofit hospice. As innovators in the field, they believed that the nonprofit model was essential to accomplish this sacred work. But that commitment is currently at risk, as Alive’s board of directors is actively considering a sale to a for-profit hospice company.
As committed hospice nurses who agree wholeheartedly with our founders’ vision, we hope to share briefly why middle Tennessee simply cannot afford to lose its only nonprofit hospice — and only inpatient hospice facility.
Nothing can be rushed when caring for the dying. From giving bed-baths to pondering questions about eternity to soothing family estrangement, it takes a team of highly trained and attentive doctors, nurses, care partners, chaplains, and social workers to wrap their hearts and minds around each patient and their family. Research from the past 20 years clearly shows that nonprofit hospices provide better care than their for-profit counterparts (Rand Report, 2023). The reason is simple. Every dollar we receive from Medicare and every dollar we raise supports our patients as they live their last days and supports their families as they grieve their loss.
Our mission is to provide loving care to people with life-threatening illnesses, support to their families, and service to the community in a spirit of enriching lives. There’s no profit-sharing with investors or scaling back staff to boost profits. We want it to stay this way. We think it should stay this way.
Alive is the only hospice in the area that has two dedicated hospice residences where people can come when their symptoms of dying cannot be treated adequately at home, in a nursing home, or even in the hospital. As specialists, we know exactly how to treat severe pain, shortness of breath, and agitation at the end of life.
Hospitals are great at curing. Hospice is great at comforting.
At nursing homes, one RN may be responsible for up to 15 patients. At the Alive residences, we have one nurse for every five patients. Jessica Blagys, NP at the downtown residence, sums it up well, saying, “The inpatient units are arguably the most important part of Alive. People who know about them make plans for their loved ones with the intention of them getting care there if needed.”
The problem is that for-profit hospices shy away from operating such residences because they are expensive to staff and maintain. There is a place for for-profit companies to help expand access to minimalist hospice services where there were none before. However, these companies preferentially select patients who can live at home and have a nurse visit a few times a week. In many cases, our patients’ lives at the residence can be measured in hours to days. For-profit hospices prefer patients who have months to live so they can bill Medicare every day regardless of whether a nurse visits them or not. It is expensive to maintain a 30-bed unit, but it’s partly what we raise money to do. If it were to close, over 100 people would die every month in terrible pain, shortness of breath, or agitation.
Because Alive is a nonprofit, we commit to taking anyone — regardless of their ability to pay.
We had a patient we’ll call “Susan” who lived a life on the streets. From her youth, all she knew was abuse, so she sought solace in drugs and men. Torie, her nurse at the downtown residence, knew that she could not change Susan’s life, but she could offer her a peaceful death. “She died a few days after she was admitted surrounded by a nurse, a chaplain, a social worker, and a nurse practitioner. We physically held her and laid hands on her until she took her last breath,” says Torie. “If we get sold to a for-profit, what will happen to the hundreds of patients we care for like Susan? We fear they will be forgotten or ignored; the residence we work at will no longer exist.”
We are also here for families and loved ones. Alive’s grief center cares for people of all ages, including children as young as three, as they grieve the loss of their loved ones. Teresa, a therapist and bedside nurse at the downtown residence, shares that approximately 50 percent of the clients at the grief center did not have a loved one die under Alive’s services. Why? “For-profit hospices in middle Tennessee refer their grieving family members to our grief center because they do not have a mature or robust program to provide the kind of grief support Alive has been offering for decades,” says Teresa.
The nonprofit model allows the grief center to raise funds to offset the generous sliding scale it offers to anyone seeking help as they grieve.
We love what we do, and we want to continue to serve Middle Tennessee in the nonprofit manner which our founders envisioned. We want to “Keep Alive Alive!” If you agree, we encourage you to sign the petition!
Do you have a story you’d like to share? You can find the submission guidelines for our “Southern Voices” series here!