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A Gift from the Heart

THE SAN DIEGO HOSPICE center, along with the entire 6.5-acre campus, was a gift from the late Joan Kroc, billionaire widow of McDonald’s owner Ray Kroc. In 1985, San Diego Hospice received $18.5 million from the Joan B. Kroc Foundation to cover the cost of planning, land acquisition, construction and interior furnishings. Kroc apparently acted in memory of her father, who spent his final days free from pain at an inpatient hospice in Minnesota.

The first patient was admitted to San Diego Hospice in August 1991. Following Joan Kroc’s death in 2003, the hospice received a $20 million gift from her estate. Hospice officials say that gift will help to ensure the future of the inpatient care center.

“We teach what we practice.We practice what we teach.” —Dr. Charles von Gunten, head of the Center for Palliative Studies


THE ART AND SCIENCE of pain management is far from static, which is why the Center for Palliative Studies was established at San Diego Hospice in 1989. Made possible by a grant from the W.M. Keck Foundation, the center provides up-to-date advances in palliative medicine to hundreds of physicians and physicians-in-training every year.

The emerging importance of palliative care is evidenced by the fact that California state law now strongly encourages physicians to “be aggressive” in treating pain. If they fail to do so, their lack of action can be considered malpractice.

The Center for Palliative Studies, the largest program of its kind in the country, attracts medical students and health professionals from around the world.

“This is truly what sets us apart,” von Gunten says. “The fact that, in addition to medical care, we provide professional education and research programs that will enhance the quality of care for countless patients facing a terminal illness.”

Who Pays for Hospice Care?


COMPASSION carries no price tag, of course. But medical care, including the many benefits of hospice care, comes at a cost. Fortunately, there are several avenues of financial assistance available to hospice patients and their families.

In 1982, Congress expanded the Medicare insurance program to include hospice care, opening the door to a number of medical and social services to many terminally ill patients and their families. Prior to that year, hospice care was not prevalent in the United States. The first hospice in the nation was established in 1974 in New Haven, Connecticut. Today, there are more than 3,000 hospice programs nationwide. More than 90 percent of those facilities, including San Diego Hospice, are certified by Medicare.

An estimated 80 percent of the people who use hospice care are over 65 and are, therefore, entitled to the Medicare Hospice Benefit under Medicare Part A. In addition to home care, Medicare and Medicaid cover short-term stays in a hospital, hospice center or nursing home. In California, Medi-Cal also covers hospice care.

HMOs and private insurance companies are not required to include hospice coverage, but many do. If a patient is not covered by Medicare or any other health insurance, most hospices, including San Diego Hospice, use donations to try to cover expenses. In some cases, patients are required to pay a portion of the cost.

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