registered nurse case manager

nursing assistant

home health aide

registered nurse

liaison

Bristol Hospice

The palliative Care side is atrocious is how the manage and run their company. The just did massive lay offs claiming to not have the income to support the amount of employees and yet, when the president comes into town, he rents a sports car instead of a less expensive option.  If you’re claiming to not have money to pay your employees, one would think you’d choose a more economical option. 

You’re very poorly trained and yet expected to know everything. Was even told that there were so many new people around the country that they couldn’t remember who they did or didn’t tell information to. They didn’t want office personnel to speak with each other about things and wanted everyone to basically keep secrets from each other. They kept their Denver location within the hospice office. They had 3 people jammed into a hot room that was basically the size of a large walk in closet. The room didn’t even have a door. It had 3 desks/people along with selves and cabinets all squeezed into this tiny area. Crazy hot in there too. They kept being promised an actual office space but it never happened. The president would continually state that he was working on it and never did. 

They knew they were going to lay people off for at least a week before doing so. Yet they didn’t even have enough respect for their employees to let them know it was coming. This would have given employees more time to submit applications for employment elsewhere had they been told it was coming. Not only did they do this massive layoff without notice, the President didn’t even bother to inform the remaining employees that it had happened. I know he was told by a remaining employee that he should send out communication to renaming employees but I was gone by this point and don’t know if he actually did and if so, when. 

A handful of providers straight out quit because they didn’t feel they were being sent into safe working environments. On top of that, they feel they weren’t supported in any regard. 

They plan on changing contracts with providers drastically but weren’t letting them know in advance. Just wanted everyone to find out the day they decided to enforce it. The president hardly ever responded to communications sent to him. You basically had to go through his assistant to get what you needed from him. 

They’ve lost track of the patients under their care. Literally, they didn’t know if the people didn’t wanted their services, if they just stopped seeing them or even if they were deceased. So in turn, they had Medical Assistants calling these poor families to figure out if they needed services or even if they were alive. 

The Palliative Care side is extremely poorly managed. Nobody knows what the other hand is doing. Heck, you could have 2 higher ups sitting in front of you, agree on something, and then have them both tell you different things later on. So basically you’re set up to fail. 

They never applied for certain certifications and if they did, never followed up to see if it had been approved even though it had been a couple years. They hadn’t even pulled an actual Business license either (at least here in the state of Colorado). Instead It seems they continued to operate under the Hospice umbrella. 

Pick another company. Pick a company that actually respects you enough as a person to let you know what’s going on. One that is actually managed properly and has actual policies and procedures in place. One that will actually train you and help to ensure your success as well as that if the company. 

Run as far away as you can from this place.

Bristol Hospice was wonderful to work for management was supportive, nurse case managers had autonomy, trusted to order DME, supplies, excellent communication with MD, Director of nursing. The social workers , chaplain, RN case managers, LVNs , CNA, office staff worked together as a family to meet the needs of the patient and their families. Number one focus was on providing excellent care , quality of life to ensure loved ones hospice diagnosis were treated with proper medication to keep patients comfortable and with a care plan that provided continued care for co morbidity s to ensure patients were not neglected. When Optimal took over Bristol and the Bristol management left. Optimal put patients and families in harms way.  A patient with Hospice Diagnosis of exacerbation of COPD, the admit nurse would discontinue all medications and order comfort pac.  Discontinue cardiac medications, discontinue thyroid medications , discontinue any supplements, and only provide the comfort medications. High doses of narcotics... some times this was done independently of the admit nurse. Without notifying family or MD.  Patients Rights were not explained to patients and family’s they were told the could not go to hospital or take there loved one to the ER if condition worsen , families were told to call the on call nurse. For whom optimal choose to have RN on call but an LVN took all the calls , triaged patients, and gave advice to families without notifying the RN who was mandated to be on call... The RNs were not notified to give advice nor were they to be woke up by the LVN.. this was directly told to me by the director of nursing at optimal Stockton. 
Optimal was reckless they sent comfort packs to patients homes before  patients were admitted or consents were signed.. I believe a patient from Jackson calif. was sent to hospital for OD after a comfort pack was sent before patient was admitted this patient was not to be admitted due to the fact they called the Fresno call center and threatened to commit suicide. Nothing confirmed the patient possible went to hospital and died at hospital. Optimal hospice of Stockton  is committing torts , I am surprised some one has not filed a wrong full death suit against Hospice. 
 Hospice organizations need to be regulated by state police or FBI.  In some cases its a legal Hit man.  Patients and family’s don’t fully understand Hospice does not mean death .. it’s means living comfortable, living as long as possible with  quality of life, quality of a loving family who wants there loved one around for as long as possible it does not mean cutting them off of all there medications and overdosing them on narcotics to induce a faster death.. Hospice organizations allow family members to administer the narcotics.  Hospice allows this even when the family members are making comments of “ dad just needs to go”. Or how long before mom passes we were planning a vacation a week from now”.  Or family members anxious to use the comfort medication when there loved one is alert and orient x 4.  Optimal hospice of Stockton needs to be investigated.  They were also found to change dates on Medicare billing...I hope some one reads this and something is done. I was fired for reporting ...

As an LVN I receive my assignment between 0730 and 0800 by text. I am typically assigned 4-5 patients/day. I review any reports provided by the RN/Case Managers then plan my  route and call the patients/families or facilities to coordinate the visits. During the visits I am checking VS, pain, respiratory, bowel, GU, neurological status  skin assessment and providing wound care as needed. I review medications with the patient and caregiver and provide education on symptom management. If necessary, the physician or RN/CM is contacted for advice or new orders. Support is provided to the patient, family and caregivers. When necessary other team members are contacted to assist with patient/family needs. Each visit is documented in the patient's record. My visits, travel time and breaks are all recorded and turned in with the visit notes by the end of the day or next day. 

I have learned the importance of team work, communication and good documentation. I have become knowledgeable in end of life care, symptom management and psychosocial issues of the family and caregivers. I am very knowledgeable in the Hospice Medicare Benefits and guidelines for admission to the hospice program and how to coordinate the admission with the hospice team.

Bristol's management has been very difficult to work with. They do not support their employees and have not provided the education and leadership needed to strengthen the hospice team and provide quality care.

 My co-workers have been wonderful. The people who are inclined to work in Hospice are usually very compassionate and caring with a good sense of humor. 

The hardest part of the job working for Bristol is the lack of support from the office. The inconsistencies with patient assignments and no feedback on the patients I see and treat. I often do not see the same patient for weeks to months. Sometimes it is very difficult to work with terminally ill patients because there is so much sadness and loss. It catches up with all of us at times.

The most enjoyable part of my job is meeting all the wonderful people from all walks of life and hearing their stories. I am honored to be able to help them during the most difficult time of their life. I feel good when I know that I have softened the sadness, taken away the fear and loneliness that families often have at this time and helped the patient to have a peaceful death.

The overly positive 5 star reviews on here do not reflect the real work environment at Bristol Hospice. Many staff feel that the supportive culture and “great training” described elsewhere simply do not exist, and that fear of speaking up allows a false image to be presented to the public.
A Culture That Contradicts the Mission
Bristol Hospice promotes a compassionate, mission focused image to the public, but the internal environment can be shaped more by unprofessional behavior, favoritism, and internal division than by collaboration or patient centered values. Leadership often appears unprepared to support staff or uphold professional standards, and training is frequently too minimal for the level of responsibility expected.
Employees may be placed into roles without adequate preparation to provide safe and consistent care. Long‑term staff and favored individuals can have outsized influence on decisions, leading to perceptions that personal alliances matter more than integrity or accountability.
Communication is often driven by gossip instead of clear, transparent information from leadership. Individuals who contribute to a divisive atmosphere may be protected or rewarded, while fairness and ethical conduct receive less attention, creating an unsafe and mistrustful workplace dynamic.
There appears to be a serious disconnect between the organization’s stated mission and daily operations. Respect, honesty, and dignity toward employees and families are not consistently observed in practice.
Pros
None observed that outweigh the systemic cultural issues.
Cons
•	Inexperienced and unprofessional leadership
•	Toxic behaviors allowed to continue rather than being corrected
•	Inadequate training and support for staff
•	Favoritism and misinformation influencing decisions
•	Publicly advertised values not reflected internally
Advice to Management
Introduce real accountability at every level of leadership. Strengthen training and enforce professional standards to support employees and protect patient care. Bring the internal culture into alignment with the compassionate mission presented to the community.

The company had a major overhaul and seemed to have diminished the former glory of the company. There is a lot of the "smoke and mirrors" going on. Certain positions have great management and overall pride in the job, others there is a lot of turnaround with the employees. The main purpose of the company although is wonderful. It provides the services we all will need someday at the end of our life cycle and it is so important to have that compassion. The caregivers are great, the company also takes care of them so they don't get burnt out. There are resources to help them with mental support, and positive reinforcements. There are some good managers and there are some that make the position not so great and you're getting chewed up and spit out. I would recommend the company on a whole to those who are in need of the services. As to working with the company, it depends on the position. Be sure to ask questions, ask where the direction of the position can go. It's easy to get "stuck" there with no advancement. The work environment can be cold and distant and yet can be "fun and enjoyable". It's hit and miss depending on the position and management in that department. If your not "in the clique" it makes for poor job quality. Definitely "who you know", and you're lucky to get "included". Working remote makes for difficulties to have that good connection with your team. That is one of the downsides, I feel it makes for employee quick turnaround. But everyone needs a job so how much will you put up with. As a company they have many good benefits for retirement and for accident and temporary benefits. Long term is everyone's goal. I'd still be there if it weren't for the poor management. They move you around and don't care if you leave. Being part of transitions are hard. If management was different I would want to work there again, as it makes for poor work conditions and no desire to take pride in your job. Then you are left with no support and a target. 

What is the best part of working at the company?
The lvns I worked with were awesome. We as con workers worked together and were supportive of one another for the most part.

What is the most stressful part about working at the company?
Management, unorganized with no compassion. The ED position is constantly being changed so the work style is constantly being changed. 
 HR is a joke and not even in the state, there is no support above from corporate and recently corporate has proven that profits are more important than patient care with the firing of 10/17 lvn with no warning effective that very day. They thought 7 lvn is appropriate for 126 patients for all three shifts. Yes they have RN 3 or 4 ONLY 3-4 divvy up those case loads. 

What is the work environment and culture like at the company?
Toxic and uncaring. The lvns for the most part stuck together to keep it running smoothly when RNs case loads are too high it falls all on the lvns and we vented and supported each other in the unorganized disarraying  mess that was management. It was a total power struggle between managers. 

What is a typical day like for you at the company?
I honestly hope they can get back to what Bristol was supposed to be but honestly a typical day is filled with family complaints, missed visits, meds missing or not filled, and trying to get ur schedule completed and charting in ur free time. Asked to work extra time and shifts then flexed off ur scheduled days later so you won’t make overtime. Work hard for little to no thanks from office. The staff care more about Family’s and patients than management and corporate ever will or even can imagine.

What is the best part of working at the company?
I absolutely love my job and the people I work with.  Our management team is the best that I have ever worked under. They really go out of their way to make sure we know that we are valued and appreciated for everything that we do. Our managers really have gone above and beyond for us. When I started working here over four years ago, I truly joined a team. Everybody works as a whole, and I am blessed to be working with such amazing people.

What is the most stressful part about working at the company?
Sometimes the workload can be stressful, but really it’s part of the job. The census will go up and down and when it is high, we do have a higher caseload. 

What is the work environment and culture like at the company?
We work as a team. Everything we do is a team effort and collaboration. We are a United location. We help each other whenever it is needed and we ensure that everything and everybody is on the same page. it is a family environment, and we are united as a family

What is a typical day like for you at the company?
I am an on-call nurse so I start my day in the office assisting with phone calls, ordering medications, assisting with whatever is needed and visiting any patients that are requiring a visit at that time. After hours, I am the primary nurse and I handle everything from referrals, medication orders, supply needs, emergencies, and symptom management. We are a 24 hour operation.

Clock in at 8am, go into your work app and see your patient list and hope that they don't randomly add more people to your work load for the day (which, they did all the time) without telling you they are adding more people. Expect to see from 7 to 11 patients in one day. Provide all cares. If you're lucky, you'll get to go to one location but more than not, you will be shuffled around to different facilities or towns. Sometimes you will not have all the information needed about your client or where your client is located. Effective communication is needed but was not the case during my time with Bristol. I did not really have an issue with work place culture other than the norm seems to be " they're on hospice" whenever I advocated for my patients, even the simplest of requests. Everytime I tried to advocate I was shut down by both the facility I worked in and my clinical supervisors. I don't feel just because a person is on hospice, quality care goes out the door. Hardest part of the job is the patient to cna ratios, it's overwhelming sometimes, especially if you have patients with behaviors or are physically aggressive. Best part of the job, spending time with my patients and getting to know them, putting a smile on their face. 

What is the best part of working at the company?
Depends on the day. Too much attrition, lack of leadership. They can’t keep EVP directors of HR.  They are either fired or quit.  The billing department has lost people left and right due to the current leader. You are in his favor when you bring in the $ but when they get in trouble so do you.  Benefits department is a joke. The manager of the department is either away from their desk, on their personal phone or comes in whenever they want.  Be careful who you talk to at the main office. They will stab you in the back if they have a chance.  People in HR work crazy long hours including Payroll. Two people who work in payroll get away with anything and everything, from working from home to putting in massive hours of overtime.  Leadership is out of touch with their employees.  Not to mention the high amounts for insurance. They make a lot of promises they can’t keep.  Save yourself the trouble of working there you will leave after a year like I did.  They spend tons of money flying people in unnecessarily for “leadership” meetings and the locations directors get bonuses but the worker bees get nothing.  This company has lost millions previously. Don’t do it. 

What is the most stressful part about working at the company?
Everything.  High expectations from employees and lack of leadership all over the company.

What is the work environment and culture like at the company?
Terrible. They don’t value their employees.

The company is very ill managed and has a focus on doing things cheap to stay attractive to buyers. My manager didnt even work in same state or even same company, but yet he knew what was best. 

This company doesn't pay well for california because they are based out of a state that has lower cost of living. They see California workers as overpaid even though rent here is astronomical. They are a small company so they have this sort of thinking in mind.

Managers only care about making money and keeping money. This hurts because everyone is overworked or doing work that doesnt apply to their job title. We have receptionist dealing with plumbing issues and billing specialists handling any mail or packages and assistants dealing with building and database/server power issues. 

If you do work here, expect for the company to be sold within a few years. Expect a lot of poorly planned projects or "ideas". Any tech support is handled off site and majority of it put on end user to deal with. Dont expect hand holding here

There are several good people and people who care, these are the old times and these people make it a bit tolerable. 

There are no get togethers, holiday parties, team building, and very little appreciation. They do celebrate birthdays, sometimes, but there isn't even a Thanksgiving potluck or anything. Its like everyone wants to stay disconnected from each other.

Top Job Titles	Average Salary
Registered nurse case manager 324 salaries reported	$89,338 per year
Nursing assistant 416 salaries reported	$21.82 per hour
Home health aide 368 salaries reported	$21.60 per hour
Registered nurse 213 salaries reported	$46.54 per hour
Liaison 181 salaries reported	$96,686 per year

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