Alive Hospice

Alive Hospice is a hospice in Middle Tennessee providing hospice care, palliative care, grief support and education about the end of life.^[1] Founded in 1975,^[2] it was one of the nation’s earliest hospice organizations and remains an independent, private, community-based, 501(c)(3) charitable nonprofit.^[3] The hospice serves more than 3,400 patients a year (more than 400 terminally ill persons and their families daily).^[4]

History

Alive Hospice was founded in Nashville, Tennessee, on November 14, 1975^[5] by Dr. David Barton, a Vanderbilt University professor of psychiatry, and the late Dr. John M. Flexner,^[6] a Vanderbilt professor of hematology.^[7] It was established early in the U.S. hospice movement, only one year after the nation’s first hospice program, Hospice of Connecticut, launched in 1974.^[8] Alive Hospice was the first hospice program in the State of Tennessee, the first in the Southeast, and the third in the nation.^[9]

Drs. Barton and Flexner, met as colleagues at Vanderbilt University in the early 1970s. The two shared a common interest in treatment at the end of life and expanding medicine’s focus on the needs of the dying. In 1972, Dr. Barton published a paper in the Journal of Medical Education titled “The Need for Including Instruction on Death and Dying in the Medical Curriculum.”^[10] In 1972, Dr. Barton and Dr. Flexner started an elective course at Vanderbilt School of Medicine focusing on the needs of dying patients.^[11] A similar course continues there today.^[12] Drs. Barton and Flexner and Dr. Miles K. Crowder (all Vanderbilt University faculty) further expounded on education about the end of life in 1980 with a paper titled “Teaching about Dying and Death in a Multidisciplinary Student Group,” which was published in Omega: Journal of Death and Dying.^[13]

Alive Hospice’s organizational structure mirrors that original interdisciplinary approach with care teams that include physicians, nurses, hospice aides, chaplains and social workers.^[14] Alive Hospice was chartered as a nonprofit organization dedicated to three core goals: providing comprehensive care for terminally ill patients and their families; offering support for grieving adults and children; and serving the community as a center for research and education.^[15]

The name “Alive Hospice” was chosen to convey the organization’s affirmation of life and living during the last months of life rather than a focus on death and dying. The word “Alive” was originally an acronym that stood for “Adaptation to Life-Threatening Illnesses Very Effectively.”^[16]

Early leadership

Dr. Barton was Alive Hospice’s first board chair from 1975 to 1977. His wife, Mrs. Lynn Barton was also a contributor at the outset and during the organization’s early years. She served as the organization’s board chair from 1977 to 1979 and hired Alive’s first full-time executive director, Iris Kozol.^[9] Dr. Flexner served as Alive Hospice’s board president from 1981 to 1982 and as its first medical director in the organization’s early years. Dr. and Mrs. Barton remain involved as members of the Alive Hospice Advisory Committee and the Alive Institute Advisory Committee today.^[17]

Significant developments

Significant developments in Alive Hospice’s more recent history include building Middle Tennessee’s first dedicated hospice care facility, Alive Hospice Residence Nashville, which opened in 2000.^[18] The agency expanded its operations with the acquisition of Hospice of Murfreesboro in 2005,^[19] enlarging its service area from eight counties to twelve counties by adding Bedford, Cannon, Coffee, and DeKalb counties. (The agency was already serving Rutherford County prior to the acquisition.)

In 2006, it opened a branch office on the TriStar Madison Campus with care teams providing care in northeastern Davidson County, Robertson County, Sumner County and Wilson County. Alive’s operations further expanded in 2007 with a new inpatient hospice unit, Alive Hospice at TriStar Skyline Madison Campus.^[20]

Additionally, in 2014, Alive Hospice received approval from the Tennessee Health Services and Development Agency to build a new facility, The Residence at Alive Hospice – Murfreesboro, in Rutherford County.^[21] In 2015, Alive Hospice was chosen by the Centers for Medicare and Medicaid Services (CMS) to participate in the Medicare Care Choices Model^[22] in conjunction with Tennessee Oncology,^[23] a pilot project in which Medicare beneficiaries who qualify for coverage under the Medicare hospice benefit and dually eligible beneficiaries who qualify for the Medicaid hospice benefit the option to elect to receive supportive care services typically provided by hospice, while continuing to receive curative services. The pilot project began in January 2016.

Services

Alive Hospice provides four core services:^[24] hospice care, palliative care, grief support, and education. Its service area includes 12 counties in Middle Tennessee: Bedford, Cannon, Coffee, Davidson, DeKalb, Dickson, Robertson, Rutherford, Sumner, Williamson, and Wilson.^[24] Its main administrative office is located on Patterson Street in Midtown Nashville.^[25] Another office and an inpatient hospice unit are located in nearby Madison; additionally, a branch office is located in Murfreesboro.^[25]

Locations of care

More than 90% of Alive Hospice patients receive care in their homes across the organization’s 12-county service area.^[26] Alive Hospice’s two inpatient facilities are Alive Hospice Residence Nashville and Alive Hospice at TriStar Skyline Madison Campus.^[27] A third facility, The Residence at Alive Hospice – Murfreesboro is planned for 2017.^[28]

• Alive Hospice Residence Nashville^[29] is a 30-bed facility located in Midtown Nashville located at 1718 Patterson Street, near several local hospitals (Vanderbilt University Medical Center, Saint Thomas Midtown Hospital, Centennial Medical Center, and Meharry Medical College). It’s a freestanding facility that opened in 2000, the first facility of its kind in Middle Tennessee.

• Alive Hospice at TriStar Skyline Madison Campus^[30] is a 15-bed inpatient hospice unit in the Neelys Bend area of Madison, just off Old Hickory Boulevard.

Pediatric hospice care

Alive Hospice serves patients of all ages, including infants, children, and adolescents.^[31] This care includes support services for perinatal patients and their families following the diagnosis of a potentially life-limiting condition. Alive Hospice’s pediatric hospice team is one of the few of its kind in the nation.^[32]

Charitable support

Alive Hospice was founded as a 501(c)(3) charitable nonprofit health care provider and continues to function as a nonprofit organization today.^[33]

Events

As part of its fundraising efforts, Alive Hospice holds a variety of fundraising events throughout the year including concert series in conjunction with The Bluebird Cafe, a regatta, and butterfly releases.

‘Two Weeks’ movie

Alive Hospice played an advisory role in the 2006 Metro-Goldwyn-Mayer film Two Weeks, starring Sally Field and Ben Chaplin.^[34] The picture was filmed in Nashville and focused on four siblings and their dying mother as they come to terms with the end of life together as a family. Alive Hospice received an acknowledgment in the film’s credits.

Future plans

Alive Hospice plans to build a 10-bed hospice facility in Rutherford County: The Residence at Alive Hospice – Murfreesboro.^[21] The Residence at Alive Hospice – Murfreesboro will provide hospice care for patients of all ages with general inpatient (GIP) care, residential hospice care, and respite. Additionally, it will feature a grief support center and community education space. The building is slated to open in 2017.

Governance and Leadership

Alive Hospice is a community-based organization governed by a volunteer Board of Directors who reside in Middle Tennessee.^[35]

President and CEO

Anna-Gene O’Neal, Alive Hospice’s CEO since 2012,^[36] holds an MBA from Vanderbilt University’s Owen Graduate School of Management. She began her career as a nurse in the Vanderbilt Emergency Department and then served as a vice president of Essent Healthcare, as well as a senior vice president of Cogent HMG^[37] leading quality and performance improvement initiatives and the Patient Safety Organization (PSO). O’Neal is a Fellow of the Nashville Healthcare Council and a member of the Nashville Healthcare Council Board of Directors.^[38]

References