The History of Mountain Valley Hospice
By Denise Watson, Executive Director of Mountain Valley Hospice & Palliative Care
I joined Hospice of Surry County, Inc. in April 1994, knowing little-to-nothing about hospice care. At the time, I wasn’t even sure why I’d agreed to work in hospice, but it didn’t take long for me to realize what a wonderful service hospice was and that I had gone through life not really valuing the end-of-life care experience or what a difference it made for patients and families. I learned so much from patients and families who impacted my life and shaped who I am today. As I sifted through historical letters, meetings, and past documents in order to write this story, I was amazed at the efforts made by those who created this wonderful organization.
The first hospice in North Carolina opened in 1979 in Winston-Salem, sparking a movement of additional hospice charters in surrounding communities. In 1980, the Altrusa Club of Mount Airy spearheaded a grassroots effort to start a hospice chapter in Surry County. Mary Alice Lewis headed the effort, strategically calling on every business, healthcare entity and leader in Surry County as well as reaching out to the Hospice of North Carolina Association for guidance. Her efforts did not go unnoticed and soon she had a steering committee to help with this great cause. In addition to Lewis, this committee included Dr. John Crane, Howard O. Woltz, Bill Pilcher, Dr. Wilford Byerly, Dr. Dale Simmons, Hester Jackson, Frances Bryant, Dr. Robert Caldwell, Mary Etta Young, Claudia Bryant, Rev. Ed Steigal, Marjorie Matthews, Florence Marshburn, and Elizabeth Calloway. They worked diligently to gain support and educate the community about a hospice chapter for Surry County. The steering committee held its first meeting on December 3, 1981, where Judy Lund Person, Executive Director for Hospice of North Carolina, was the guest speaker. Judy provided guidance and support throughout the Surry Chapter’s beginning process, and now she serves as Vice President of Regulatory and Compliance for the National Hospice & Palliative Care Organization.
By February 1983, Hospice of Surry County, Inc. was a non-profit corporation, and on December 1, 1983, they began to take patients into hospice care. Services were provided by volunteers only – there was no paid staff. Pat Ashworth was the first director for the hospice program. Operations were supported by contributions alone through the generosity of local businesses, memorial funds, churches, civic clubs, United Fund, individuals, donations, and grants. At the end of 1984, Hospice had served 33 patients and their families. There were 82 trained volunteers, a hospice coordinator, and a part-time social worker on staff.
In 1984, a new state law was passed requiring hospices to be licensed by North Carolina. Hospice of Surry County, Inc. became licensed on November 1, 1984. They continued to operate solely on contributions for the next six years until becoming Medicare-certified in January 1990. As you would expect, the capacity to serve more patients quickly grew, and hospice services proved to be one of the most cost-effective services for Medicare beneficiaries.
In 1993, Hospice of Surry County, Inc. expanded services further into the county and opened an additional location in Elkin, NC. In 1996, the hospice became an affiliate of Hugh Chatham Memorial Hospital, which allowed greater partnership with the medical community and offered the employees better benefits. In 1997, an additional office was opened in Yadkinville after the acquisition of Yadkin Valley Home Health & Hospice by Hugh Chatham Memorial Hospital, which was previously owned by the Health Department. By 2004, Hospice of Surry County, Inc. was serving 160 patients a day with more than 100 volunteers to support operations.
During this time, discussions were being held about building a hospice-owned inpatient facility to better serve patients who were unable to remain at home for care. Soon thereafter, the Board of Directors approved moving forward with the project and began soliciting support. An application for a certificate of need was approved by the state. As Hospice engaged the community and evaluated the potential for fundraising this project, the boards of Northern Hospital of Surry County and Hugh Chatham Memorial Hospital agreed to bring Hospice of Surry County, Inc. and Northern Hospice into a combined entity. In October 2005, the two hospice programs became one, taking on the new business name: Mountain Valley Hospice & Palliative Care (MVHPC). Services were also expanded in 2005 into Galax, Virginia, and later moving to Hillsville. Since then, services have expanded even further by adding offices in Stuart and Martinsville, Virginia; and Pilot Mountain, North Carolina. The Joan & Howard Woltz Hospice Home, a 20-bed in-patient unit, began serving patients in March 2009. This facility has proven to be an asset to our community by meeting the needs of those we serve. In August last year, we opened an additional six-bed facility, the SECU Hospice Care Center of Yadkin, providing residents in Yadkinville and surrounding areas an option for end-of-life care closer to home.
Today, hospice care is a highly regulated and competitive market. Hospice organizations are challenged to meet many patient eligibility requirements and must consistently prove that a patient is eligible for services. Documentation requirements have more than tripled over the years and must support this eligibility. Hospices are also now required to hire or contract physicians to perform face-to-face visits with patients who have been in hospice care for more than six months, to ensure those patients are eligible to continue services. Unfortunately, hospices cannot bill for these required physician visits and must pay for the services out of the current Medicare reimbursement model. At the same time, reimbursement has changed and decreased over the years. Currently, hospices are paid a daily rate for services regardless of the cost to provide services. Reimbursement is based on a tiered model where a higher rate is received the first 60 days of care, then decreases significantly for any days greater than 60. During the last week of life, hospices can get an increase in reimbursement depending on the number of visits made. Additionally, there are multiple non-profit and for-profit hospice providers in our service area, which has resulted in a more competitive market. Hospices find themselves investing more and more dollars in marketing just to remain viable. All these factors have made it challenging for hospices financially, especially those that are providing the highest quality care, serving rural populations, offering multiple programs, and operating inpatient care centers.
As a non-profit provider of 35 years, Mountain Valley Hospice & Palliative Care focuses its mission on improving the quality of life to those with a limited life expectancy and their families. Today, MVHPC provides services from 7 offices and 2 hospice care centers across a 17-county footprint in North Carolina and Virginia. In addition to hospice services, MVHPC provides a variety of programs that include Palliative Care, Transitions, and the Medicare “Care Choices” Model. We also offer specialized programs for Veterans, children, and pets, with bereavement services offered after the death of a loved one. Each day, more than 500 patients are served altogether in Hospice, Palliative Care, Transitions and Medicare “Care Choices”, and another 2,000 are served in our bereavement program.
Our 280 employees and 475 volunteers live by the MVHPC motto, the “Mountain Valley Way”, which means we are committed to providing exceptional care to every patient every time. Our patients are our number one priority and deserve the very best care, respect and dignity we can provide. At the end of the day, our patients and the care they receive tell the story of our mission, vision and values.
For me, the hospice journey has been phenomenal. Oh, the work we have done! And for Mountain Valley Hospice & Palliative Care, 2018 has been a year of tremendous growth. We are Mountain Valley Strong!