‘A monumental feat’ for Hospice of MV

Nonprofit achieves Medicare certification and accreditation.

From left, Hospice & Palliative Care of Martha's Vineyard board member Dr. Jim Butterick, board president Rev. Sharon Eckhardt, clinical director Chantale Patterson, executive director Cathy Wozniak, and board vice president Robert Sarno outside Hospice headquarters. — George Brennan

November is hospice and palliative care month and at Hospice & Palliative Care of Martha’s Vineyard, there is much to celebrate and highlight as the 41-year-old organization ushers in a new era of Medicare certification.

During a conversation with The Times Monday, the nonprofit’s top executives and board members sought to dispel any myths that the Medicare certification would somehow change the services provided and what hospice care is all about. And they wanted to make it clear to the Island’s generous donors and philanthropists that they still need their support, as well.

Cathy Wozniak, executive director of Hospice & Palliative Care of Martha’s Vineyard, said the goal of the nonprofit remains the same. “Hospice is about the goals of the family. We’re not there to tell them what they want,” she said.

The nonprofit began the arduous process of Medicare certification in 2019 knowing that it was a way for them to provide their services to all eligible Islanders.

“It was clear to me that the numbers of aging people on the Island were going up and the need we have now would certainly be greater going forward,” Dr. Robert Sarno, the board’s vice president, said. “That’s why I was a big supporter from the beginning when I got on the board for going for Medicare certification. There was some reticence by board members not to do it, but I think in the end we realized this is in the best interest of our operation.”

Dr. Jim Butterick, who has served as the board’s president and is now its clerk, said he was concerned about the nonprofit’s reliance on grants, events, and what he called the “largesse of the Island.” “Donations from the island have supported us sublimely over the years. We’re 42 years old now. … To provide the full benefit that Medicare does provide in terms of hospice coverage. There’s a lot of things like disposable medical equipment, palliative care, you have to provide if you’re take Medicare patients. I suppose we could have done that without the ability to bill Medicare. But we would have had to raise even more money.”

In recent years, the gap grew wider between what was being brought in and the expense of providing the hospice, palliative care, and counseling services for bereavement, Dr. Butterick said. “We hired a consultant in the fall of 2019, and the consultant came back and said one of the people — a long time Islander — told him: ‘I know we’re supposed to say, Medicare is a bad thing and I’m not sure why’,” Dr. Butterick recalled. “The truth of the matter is, Medicare is not a bad thing. Medicare and the Medicare hospice benefit has been around for 40 years. It’s of tremendous value to people.”

The board members praised Wozniak for her steady hand during the process, which included hiring new staff, building more infrastructure, and codifying the quality control and procedures that were already in place. Not only did they receive certification, but Hospice & Palliative Care of Martha’s Vineyard is also accredited by the Community Health Accreditation Partner (CHAP).

“It’s like having the Good Housekeeping seal of approval,” Wozniak said. 

All of it was done without the board being able to meet in person because of the ongoing COVID-19 pandemic, Dr. Butterick noted.

The paperwork is done. The dozens of contracts with ambulance companies, the hospital, and others are filed, as are the hundreds of policies and procedures, Wozniak said. 

“It’s formalizing a lot of the practices we were already doing. We had quality control, but we had to really formalize it with an actual plan and a policy and a calendar so that when we were certified we could actually show,” Chantale Patterson, RN and clinical director, said. “They did not find one deficiency” during the accreditation process, she added.

Wozniak called it “a monumental feat” to get certified and accredited. “It’s not over. We have to hunker down on what we have to be doing. We have to always be doing improvements,” she said.

Not only are their myths about Medicare to overcome, but hospice itself is not always understood. 

“The notion of hospice is not that we’re going to help die. We’re going to help you live your life to the fullest every day until you do die,” Dr. Butterick said. “It’s not like we’re promoting death. That’s been one of the biggest revelations for me.”

Eckhardt agreed. “I spend time with people who are dying. It’s amazing how many people don’t know about hospice,” she said. 

Patterson noted there are a lot of misconceptions about what hospice actually is. “We look at the patient and family at the center of their care when they’re in the last stages of life with a life-limiting illness. So we come in with an entire team of folks — nurses, counselors, spiritual counselors, aides, volunteers, including patients and families and their physicians as well and really determine what is most important to them at the end of life and that’s what hospice care is all about. It might be symptom management and it might be getting them on the beach to fish one last time. They decide what the goals are and then we are there to help them make it happen.”

There is no hospice facility. Many hospice patients are cared for at home, at Windemere, or at Martha’s Vineyard Hospital.

“That’s one of the myths is that hospice is a place. It’s the place they want to be in their last days. A lot of people think it’s just for cancer. It’s not just for cancer. It’s for anyone who has a life-limiting illness,” Wozniak said. 

And it’s not just for those final days. Someone with a life-limiting illness, ultimately confirmed by a physician, is eligible for hospice care.

“We want them to be on as early as possible because there’s so much benefit, not just from the nurses but from the social workers that can help them with resources, the counselors, the spiritual counselors. They meet their needs and family needs,” Wozniak said.

Now back to how this was all funded. Dr. Butterick pointed out it was a generous benefactor, the late Katharine Graham, former Washington Post publisher, who provided an endowment for the hospice care on the Island. A big chunk of money — they didn’t say how much — was invested to get the Medicare certification. 

And for those other Island philanthropists who have shown generous support, Wozniak had this message: “We don’t want people to think now just because we’re Medicare certified we don’t need to fundraise. We need to fundraise because medicare does not cover everything … We cover medications, we cover durable medical equipment and we cover CNA services. For us to ramp up to be medically certified, it was a tremendous investment of this board,” she said. “We’ve had to add infrastructure, a [medical records] system, and more staff. So philanthropy is important to us moving forward.”

Denise Schepici, CEO and president of Martha’s Vineyard Hospital, offered her congratulations on the achievement of Medicare certification and accreditation. “Hospice of MVY is an important community organization and its recent accomplishment of achieving Medicare certification ensures access and stability of services as well as great quality and compassionate care,” Schepici told The Times. “We treasure this partnership and the great team of professionals who dedicate themselves to this work. We wish them continued success.”

All of those in the room Monday have either had a family member in hospice or cared for someone near death. They come by their passion for hospice care honestly.

“It’s a special group of people who want to do this work,” Patterson said. “It’s not about the money. It’s about how you can make a difference for that person going through a process that we’re all going to go through and normalizing it for them and making it as peaceful an experience as it can be.”

Wozniak said the end of life is as important as when you’re born. “It should be celebrated and it should be serene and peaceful as you leave this world.”


  1. On November 1, 1983, when the Medicare Hospice Benefit became law, I was the Deputy Director and Director of Finance of the nation’s first Medicare-certified hospice program in the country. Shortly thereafter, we became the first Joint Commission-accredited hospice. It took a great deal of work. And it was well worth it. But the certification comes with requirements, some of which Martha’s Vineyard Hospice was not willing to comply. With those limitations, I wish Hospice the best of luck.

  2. Hospice and Palliative Care of MV provided compassionate care for the past 40 years as a volunteer hospice. It recently was accredited by CHAP (no deficiencies found during the 3-day survey) and certified by Medicare as a provider of hospice services. I served as CEO of a hospice in SW CT from 1980-2001 and on the Board of the National Hospice Organization from 1984-1990 – I know very well the resources and effort it takes to obtain and maintain Medicare certification. There are many reasons why MV Hospice did not apply for Medicare certification in the past, but it has now and with full commitment to continuing to provide excellent, compassionate care. I am proud to now serve as a member of its Board of Directors.

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