Bending the Health Care Curve

While a first-year medical student at the University of Florida, Deborah Morris visited her grandfather in a room he shared with another patient in a nursing home.

He was in his 80s, a retired military man. Tough, he had beaten esophageal cancer, but his heart, finally, was dying.

He had ping-ponged between a hospital and the nursing home for some time, and now he was in a bed at the end of a hall, as far removed from the nurse’s station as it could be. When his daughter arrived, he was gasping for breath and pleading for help.

“As a medical student, I said to myself, ‘We have got to do better than this,’” Morris recalled. “It was so far from OK. Really, it was that experience that drove me to pursue a career in hospice and palliative medicine.”

Morris moved to Tallahassee from Virginia about three years ago and worked for a time in palliative care at Tallahassee Memorial HealthCare (TMH). In February, she became the medical director at Big Bend Hospice (BBH).

In relocating, Morris said, she and her husband Tod, a TMH oncologist, sought a community that is “committed to caring for everyone.” In Tallahassee, they are convinced they found such a place. Morris points to community support for an in-hospital hospice unit at TMH as evidence for that belief.

As of this writing, the First Commerce Center for Compassionate Care (FCCCC) at TMH, which will be operated by BBH, was expected to receive its first patients in mid-November. The approximately $6 million project will provide eight acute care beds reserved for patients nearing the end of life.

Typically, those patients will be transferred from TMH to BBH and will have become so vulnerable and fragile as to be unlikely to survive even a two-mile ambulance ride from the hospital to BBH’s 12-bed Hospice House.

For terminally ill patients too sick to be transported, the only option had been to remain in a sterile, noisy hospital room.

“They need an environment that is appropriate for end-of-life care,” Morris stressed. “TMH is a great hospital with great doctors and nurses, but the hospital space, itself, is not a hospice space. A favorite nurse of mine when I was in hospice training said, ‘We labor coming into the world, and we labor going out.’”

First Commerce Center for Compassionate Care rooms — the credit union was awarded naming rights given its $1 million contribution to the project — were designed as places where patients, family members and caregivers can comfortably gather. They have the feel of a room in a home.

Photo and renderings Courtesy of Big Bend Hospice

Wiring is hidden. The patient bed has a headboard. The couch folds out into a guest bed. The rooms are conducive to efforts to meet spiritual, psychological and family needs. One of the rooms can readily be converted for use in pediatric cases.

In October 2019, Lee Hinkle and Rheb Harbison, then the board chairs at TMH and BBH, respectively, met to discuss how the two organizations might benefit by a closer relationship. Their meeting led to one between TMH CEO and president Mark O’Bryant and BBH CEO and administrator Bill Wertman. The two chiefs have been doing lunch ever since.

“Our first meetings were the genesis of the inpatient hospice unit at TMH,” Wertman said. “The discussion continued for the better part of two years concerning what it might look like. It’s a win-win. We benefit by having our acute care nurses in the hospital, and the arrangement helps TMH reduce the mortality rate within the hospital. Hospitals can be scrutinized very heavily for that.”

Photo and renderings Courtesy of Big Bend Hospice.

Like Morris, Wertman was profoundly affected by the passing of a relative, his mother, who died two years ago at age 89. For the last 15 years of her life, Wertman served as her caregiver. 

“Let’s face it, there is a very specific reason that people need our services,” Wertman said. “It’s not until then that they find out what the true benefit of hospice is. You are grieving, and you are dealing with the sadness of what’s coming and still trying to be strong for your family and, in my case, for my mom.”

Wertman said that even given his years of service as a hospice CEO — he joined BBH in 2015, initially as human resources director — “I learned a great deal about hospice when I was vulnerable and I needed their help.”

BBH, which operates with a certificate of need issued by the state, serves 6,500-square-mile Area 2B comprising Franklin, Gadsden, Jefferson, Leon, Liberty, Madison, Taylor and Wakulla counties. It employs 279 people and is the third-largest health care provider in its service area behind TMH and HCA Florida Capital Hospital.

On Aug. 10, its patient census stood at 435, including its palliative care program.

To staff up the new unit, BBH was engaged in August in what Morris called a “huge recruiting push” aimed at hiring nurses, providers and care aides. The search, she said, was focused particularly on prospective employees who enjoy acute care.

“We’ve had a lot of interest from nurses who have worked in hospital settings in critical care,” Morris said. “Many have been hearing reports about this unit for years, and they are very excited.”

Their interest level has been mirrored by community support for the project.

“First Commerce was amazing for us,” Wertman said. “Here you have a credit union that you wouldn’t think of as supporting a health care effort in a hospital, but one of their directors who was familiar with what we’re doing went to bat for us and their board overwhelmingly approved the donation.”

As of August, a capital campaign that was launched in late 2022 had sailed past the $4 million mark.

Founders Wall — A display will recognize people whose contributions made the hospice center at TMH possible. First Commerce Credit Union made a $1 million donation to the project. Photo Courtesy of Big Bend Hospice

“That shows the level of compassion in the community for hospice, and it also speaks volumes to Dena’s abilities and her connections; she has made this happen.”

About BBH Foundation president Dena Strickland, Wertman said, “Many people love her and respect her, and when she asks, they give.”

Meanwhile, Wertman is encouraged that the TMH-BHH collaboration suggests possibilities for “a continuum of care that is not so fragmented and disjointed, but more aligned and more accessible.”

At those Wertman-O’Bryant lunches, important chatter takes place between bites.

“I think in the near future, we will see a new kind of health care delivery in our area that will be pretty much unparalleled elsewhere in the country. There aren’t a lot of projects like it, and this one has a lot of momentum right now.” 

Want to Help?

Big Bend Hospice continues to receive donations to its First Commerce Center for Compassionate Care project. Contact Foundation president Dena Strickland at (850) 878-5310 for further information.