VITAS VITAS Innovative Hospice Care Poor training and treatment leads to bad experiences, the dollar is king Middlebury, Connecticut

VITAS is not a company I would ever want to support in any way.  Some patients and families have good experiences, but this is due to the kindness and hard work of the front-line staff (nurses, aids, social workers, chaplains, and sometimes doctors) who are never really rewarded for this and often are mistreated.  Many other people have bad experiences because the disorganized, money-hungry, and dishonest nature of the company shines through in their interactions. 

The "Vitas values" they claim to support, and splash all over their literature:
1.  Patients and families come first
2. We take care of each other
3.  I'll do my best today and even better tomorrow
4.  I am proud to make a difference.

Here's the real story:
1.  Patients and families come first only in the ways necessary to ensure the money keeps rolling in.  They will be as nice as pie when trying to convince you to sign on, or when they know they have screwed up and want to avoid a lawsuit, or when you begin to make noise about being dissatisfied and they are afraid they will scare away referal sources.  On occasion, they really will do something nice for someone (generally and family member or friend of either a management employee or an important referral source like a prominent MD) but typically money and reputation are behind it all.  But when the patient needs a more expensive medication or product than the cheapest out there they are probably going to be SOL.  Vitas has even started rationing gloves for their 24 hour care patients:  they are not allowed to get a box at a time, only 20 individual gloves.  And the inpatient unit runs out of supplies constantly, and doesn't use several important items (like mouth moistener) because of cost.   They will be nice if you start talking about leaving because every day you are on service they are getting paid, regardless of how much they actually do for you.

2.  They take care of their management only.  The front line clinical staff gets mistreated horribly, unless they have connections:  favoratism and unfairness run rampant, often resulting in unqualified people being placed into positions they can't handle and wonderful qualified staff getting passed over time and again.  They don't care at all about retention, their turnover rate is horrendous and many staff don't even stay through orientation because of the high work loads and poor support.  They refuse to work with people on scheduling, reducing their hours, or anything really, even if the person quits:  many nurses have quit in the last year because they wanted to reduce their hours and were denied.  So, good experienced staff is lost because the company doesn't want to budge.  Training is awful and often non-existant.  Also despite how they talk about safety, staff members are repeatedly sent into unsafe situations even when they have been threatened or assaulted.  Recently people have had knives thrown at them, been threatened by intoxicated relatives, had guns waved at them, had people try to hit them or hitting each other, had families using drugs right in front of staff and the patient, and pateint's families stealing their medication.  The staff member who had knives thrown at him requested not to return and was told he had to.  And even when problems are reported to the company they never call the state or social services no matter what is happening to the patient because they don't want to lose customers.  They are so concerned about how their inpatient unit looks that they have horrible uncomfortable recliners instead of cots for families because the manager thinks cots look too "institutional."  They refuse to utilize bed alarms for patients who are confused and climb out of bed because they are too hospital-like and refuse to pay sitters unless the patient is REALLY out of control--even patients who have fallen multiple times in a week and still climb are not given sitters, and staff doesn't get any help monitoring them even when the staff and families ask for it. 

3.  See above.  In addition, any time a mistake happens the real action is mostly about a*s-covering.  Very little effective changes are ever made.  Suggestions from clinical staff to improve safety and quality are rejected due to either budget or appearances.  Even in situations where patients have been harmed, no changes that cost any money are put into place.  Staff is given packets of information to read and tests to take to satisfy the state, but when they point out they do not have the resources to really keep patients safe or even to follow the instructions in the packet they are ignored.  All of the focus is on appeasing the family so they do not sue or complain, resulting in other patients being ignored and having less help because all the clincial staff is forced to spend hours catering to the disgruntled family's ever desire.   Any "improvement" is surface level only.  Management glazes over the real problems in favor of just keeping the money rolling. 

4.  They are recognition-hungry but choose to gain it by lip service and showering key people (doctors, hospital owners, nursing home administrators) with lavish lunches and receptions.  They are dishonest.  They do truly help a small percentage of their patients by providing uncompensated service, etc., but the vast majority get screwed and it is almost always the patients with influential connections or those who threaten the company with bad publicity who receive this "charity" that Vitas then publicizes madly. 

In addition, the hospice doctors and nurses, especially in the inpatient unit, are very reluctant to use high doses of meds.  They start off at low doses and make changes very slowly.  Maybe this works for some patients, but walking down the halls you see sefveral who obviously are not comfortable despite whatever "interventions" they are doing, but the staff just shrugs and says there is nothing more they can do.  One doctor even told someone that the patient couldn't get any more sedation even when the patient was begging to be sedated (not killed, just asleep) because it might cause heart failure--the man was a death's door!  Hospice is supposed to provide comfort over all other priorities, but if their usual protocols fail they are very reluctant and slow to go above and beyond the ensure patients are really comfortable.  Families are told all the taime "there is nothing more we can do" even as three staff members hold the patient down for horus because they are so confused, or the patient screams and cries in pain.  They say they offer sedation as a last resort for people with horrible suffering but in reality they will always make excuses or say it isn't possible when families ask for it. 

Don't go with Vitas.  If you need hospice services choose one of the non-profits.  Vitas has flashy facilities and talks a good game and does have some nice employees but they are too money-hungry to be bothered with really making sure their patients are safe and comfortable or with supporting their employees or even giving them what they need to do their jobs.  If you are looking for hospice look elsewhere, they may look nice but it really isn't worth the risk.