R.I. hospice center invests $3 million in expansion to meet growing demand for care

Additional beds will allow HopeHealth to offer end-of-life care to more people, but staffing is still a challenge

Hope Health, Rhode Island’s only freestanding hospice center has increased its capacity by 25 percent after a year-long construction project completed recently.HopeHealth

PROVIDENCE — Rhode Island’s only freestanding hospice center invested approximately $3 million to increase its capacity by 25 percent to meet the areas growing demand of specialized end-of-life care.

The construction project at HopeHealth Hulitar Hospice Center in Providence completed in July, which added six beds to its existing 24-bed unit. It was paid for with a $2.8 million bond approved by the Rhode Island Health, Education and Building Corporation in November 2019 and a $270,000 grant awarded by the Champlin Foundation to cover the cost of rebuilding the two elevators that were installed during the building’s original construction in 1975.

Diana Franchitto, CEO and president, said the facility was a former nursing home, which HopeHealth purchased through receivership in 2008. She said it was then that it became the only hospice inpatient center in the state.

She said prior to the expansion, many patients were being put on a wait list, which she said “should not happen to anyone” in their final days.

“I often refer to [HopeHealth] as the the ICU of hospice care,” said Franchitto of the facility. “It’s really to serve the patients that can’t stay comfortable at home. They have significant pain and symptom management issues.”

Franchitto said each of the patients in the center, which is often nearly or completely full, need care around-the-clock, which family members often cannot provide at the end-of-life.

She said while she understands most patients would rather be cared for at home in their final days, she said the staff tries to make HopeHealth as home-like as possible in a calming and peaceful environment.

Each patient, who stays for an average of three to five days, has their own room. And throughout the pandemic, when many nursing homes and assisted-living facilities closed visitation, HopeHealth continued to allow loved ones (and pets) visiting.

“They know their loved one is seriously ill. They too, are processing what’s happening with their own family,” she said. There are interfaith centers, grief counselors and programs (which are offered to the families for free for up to a year after their loved one has died, including the Camp BraveHeart program for children), a children’s room, and showers for loved ones who are staying overnight.

The completed construction comes as HopeHealth, like many health care facilities in the state, are struggling to meet staffing needs.

The center saw an average of 1,540 patients per year pre-construction, without the added six beds.

According to Dr. Edward Martin, chief medical officer, HopeHealth’s center isn’t “like a long-term care facility.” There are three nurses, or more, caring for 15 patients instead of other facilities where one nurse could be caring for eight to 10 patients. There’s also a handful of physicians monitoring the floors.

After the state’s vaccine mandate required all workers in the field to be fully vaccinated, 12 workers lost their job because of the mandate, which did include seven nurses, four hospice aides, and one other clinical position.

The center is actively recruiting, which includes $5,000 sign-on bonuses for nurses and $2,500 sign-on bonuses for certified nursing assistants.

“I think the toughest struggle is dealing with the collateral damage of the exhaustion and the fatigue. When you think you’ve been through the worst of it, you start to have other issues,” said Virginia Magnan, clinical director of HopeHealth. “There are shortages — whether it’s staffing or material.”

The burnout, at this point in the pandemic, she said, “is very real.”

“But this is very life-affirming work,” said Magnan. “[From a family’s point of view], if you think of quality of life versus end-of-life. Lots of people come here and think ‘this is the end.’ But then they get here and think, ‘this could be the beginning of me not having to be the nurse at home and I get to be the family member.’ Maybe this is the beginning of some sort of healing with family members or some quiet time at home because the patient isn’t in pain or hallucinating.”