Hospice of the Gorge faces state inquiry

The state Department of Justice Civil Enforcement Division is examining allegations of a breach of fiduciary duty by the board of directors for the Hospice of the Gorge.

In an Oct. 4 letter to board president Charles W. Bugge, Reed Drew of the DOJ wrote that a recent high level of turnover "suggests that the Hood River office may have difficulty in continuing to provide hospice care for its service area."

That area includes seven counties on both sides of the Columbia River, including Klickitat and Skamania counties in Washington; Hood River, Wasco, Sherman, Gilliam, and Morrow counties in Oregon. The DOJ references the departure within the past month of at least six employees, five of whom are registered nurses, having resigned from the Hood River office.

"According to our review of the Oregon Hospice Association's Web site, the HOG (Hospice of the Gorge) is the only registered hospice in the Hood River area. Therefore, any prolonged drop in care provided by your organization may leave a gap in the area's hospice needs," wrote Drew, who is charitable audit coordinator for the DOJ.

As of Wednesday, DOJ public information officer Victoria Cox said they had not received a reply to their request for information from the Hospice board of directors.

"We gave them three weeks to respond and we hope they took it seriously," she said.

Hospice's Executive Director Deborah Whiting Jaques said Thursday evening that the letter was in the mail and that Hospice employs 15 full -- or part-time R.N.s and four R.N. managers.

"We are staffed to care for our patients and their families," Jaques said.

Former Hospice nurse Merilee Webster disagrees. She is one of the five nurses who resigned and said the difference in philosophy of how hospice should deliver services to its patients was a year-long dispute between the hospice board, executive director and a group of 15 employees.

"A nurse can't do hospice unless she has the feeling and compassion for the people and the families," Webster said.

She has worked in the hospice care field for 11 years, six-and-a-half years here and four and a half years previously in Hillsboro.

Webster said the shift in health care delivery during the past year at Hospice included an increase in patients for nurses up to a caseload of eight patients, which she and the other 14 felt led to what DOJ termed in its letter "an abusive and hostile work environment."

"You have to take into consideration the mileage, how sick the patient is; so it depends on the situation," Webster said. "That is what is hard to project. On the Oregon side, you may have a lot of people in facilities. On the Washington side, it is different."

She felt a change to having one on-duty nurse for both Oregon and Washington sides in the west end was spreading nurses too thinly to cover patients' needs.

"You can't be at two deaths at the same time," Webster said.

DOJ questioned in its letter whether the board had taken sufficient action to correct the work environment and if "operational changes have resulted in a decrease in the quality of care provided to patients."

Bugge responded that he concurred with Whiting Jaques that the board had been responsive to the situation. Whiting Jaques said the allegations were unfounded.