Mark

Mark Cohen

Publisher & Editor, Hospice News Today

Mark has written several Random Parting Thoughts on media coverage, issues management, and the hospice community. We appreciate his thoughtfulness and wisdom on these topics, and please find them posted below.

Media Monitoring, 12/19/23
I’ve been doing media monitoring my entire career—starting in 1977 as a low-level staffer in the Jimmy Carter White House. It’s an understatement to state that the media have experienced revolutionary change over the past 45+ years—massive changes in ownership (rarely for the better), the rise of social media (both good and bad), the decimation of newsroom staffs, the closure of hundreds of local papers, the nationalization of local TV news, the decline of radio news, and on and on.
What does this mean for hospice?
It means there are both many fewer and many more places for news about hospice and related fields to appear. It means that many of the people reporting on hospice today have neither the experience nor the basic knowledge of healthcare that we saw as recently as a generation ago.
In the end, it means that providers that think it best to stick their head in the sand often can succeed with that strategy. And it means that those providers who still want (and need) to tell their story have to work harder—and better—to get their story out.

News Releases (Part I), 12/20/23
With the decline in local media, as discussed in Tuesday’s Random Parting Thoughts, the role of the news release becomes both less important and more important. Less important because there likely are fewer media outlets that will run your release. More important because news releases increasingly may be one of the few remaining ways to disseminate news and get your message out.
While there are fewer media outlets that might carry your news release, the draconian cuts in newsroom staff mean more and more of the remaining media outlets are that much more likely to accept and run your news release as is. In addition, the “newsroom” on your website (if you have a newsroom function on your website) and your social media feeds have been ever more important channels to disseminate your news.
All of which raises the question: Is your news release ready for prime time. Does it meet the basic standards of journalism? Does it read like a news story?
I’ll discuss that in my next message.

News Releases (Part II), 12/21/23
The questions I left you with Wednesday morning were: Is your news release ready for prime time? Does it meet the basic standards of journalism? Does it read like a news story?
To be candid, one of the most depressing things about publishing Hospice News Today these past 11+ years has been seeing the high volume of badly (not just poorly) written news releases scroll by on my computer screen. From providers large and small, for-profit and not-for-profit. From vendors large and small across every sector.
The decline in quality of news releases clearly reflects the diminution of hospice public relations staffs over the years: Fewer, less experienced staff trying to do the job. It’s understandable that in today’s world hospice providers and hospice vendors are hiring communicators with primary expertise in social media. But being able to write a compelling tweet or Facebook post does not automatically qualify someone to write a news release that won’t make a seasoned (curmudgeonly?) editor like me roll his/her eyes and reach for the trash bin.
The standards of good, sound journalism style still apply in nearly all cases to news release writing:

Employ what’s known as the inverted pyramid style (the most important facts in the first paragraph cascading down to the least important fact in the final paragraph).
The lead paragraph needs to answer six questions: Who, What, When, Where, How, and Why (also known as the “5 Ws,” despite the presence of the “How.”) And, of those 5 Ws, the least important one most often is the “When.” The inverted pyramid style also applies to the lead paragraph: 99 times out of 100, the “When” should not be the first thing you read in a lead paragraph.
Utilize the active voice, not the passive voice; use action verbs, not being verbs. The worst verb to use in a lead paragraph is the shortest: “is.”

So that means that a news release (or guest column) that begins: “November is National Hospice Month.” is an example of just about the worst possible lead that can be written. Yet if I had a dollar for every time I’ve seen that exact lead sentence over the past 11 Novembers ...
[And, if you’re wondering, news releases that begin: “Today, ...” similarly cause the eyes to roll.]
More on press releases tomorrow.
Thanks for reading.

News Releases (Part III), 12/22/23
A Mildly Cranky Rant about a Couple of News Release Pet Peeves.
When did words like excited, thrilled, pleased, proud, honored, and the like take over news releases? Whenever it occurred, it was a sad day for journalism, public relations, and good writing.
From a journalistic standpoint, I simply don’t care about your feelings. Hard stop.
When the best thing that newsmakers have to say about a C-Suite hire or rollout of a new service is that they’re “thrilled” or “excited,” the editor in me asks, “Is that all they’ve got? Why don’t you tell me not about your feelings but rather why this is news, why this is important.”
From a marketing standpoint, it’s never about you and your feelings. It always (should be) about your customer/audience/the community you serve. Your state of excitement is irrelevant to that. Hard stop.
If a provider or vendor wants to be excited or thrilled, save it for your donor/customer newsletter. But let’s keep it on a professional level in the news releases meant for broad, external audiences.
And when did solid, appropriate, sound verbs for journalistic attribution like said, stated, explained, detailed get replaced by “shared” and “expressed”?
You can read 100 straight news stories in well edited news sources like The Associated Press, New York Times, Washington Post, Wall Street Journal and Bloomberg and probably never see a quote attributed to a speaker with the verb “shared” or “expressed.”
People don’t “share” facts. They say them. They state them. They “share” opinions or feelings.
And, as for expressed: As a verb, it describes what the veterinarian does to my cat’s anal glands during the cat’s annual exam.
People don’t “express” statements of fact. They say them. They state them. They “express” opinions or feelings. And opinions and feelings are not something that should be one of the first things you read in a news release.
If you read Hospice News Today carefully, you’ll note you rarely see examples of this kind of writing in the excerpts I publish. That’s because I try my best to leave them out.
Thanks for reading.

A comment or two about No Comment, 12/23/23
Readers likely have noticed that I never fail to mention when a provider under negative scrutiny either responds with a “no comment” or fails to respond at all to a media request for comment. As in today’s newsletter.
And that’s because I’m trying to make the point that, even in a legal matter, “no comment” is never a successful public relations/media relations/reputation management strategy. You might as well just hang a guilty sign around your neck.
Instead, there is almost always a way to say something in a no comment situation, even if the statement doesn’t really say anything.
Legal Counsel will almost always advise a “no comment” strategy. But keep in mind that Legal Counsel is solely concerned with winning in the court of law and is really not concerned about winning in the court of public opinion.
For example: When a lawsuit is filed alleging negligent care, the plaintiff’s attorney often will file the suit minutes before the clerk’s office closes at the end of the day. And then dump a press release on local media, causing an over-excited reporter to call after business hours seeking immediate comment—even before you’ve been served with a copy of the lawsuit. And it’s worth noting that many reporters seem to enjoy writing things like: “The hospice did not respond to a request for comment before publication deadline.”
So, what can you say? You can—and ought to—say things like this:

“Plaintiff’s attorney has every interest in trying this case in the media. But that is not the proper venue, and we choose not to play this litigator’s games. (We’re sorry to see your publication is willing to do just that).”
Or: “It’s worth noting that the media received the news release before we’ve been served. Is this about a legitimate legal case or just a publicity stunt?”
Or: “It’s a cliché to state that we can’t comment because we have not yet seen this lawsuit. But just because it’s a cliché doesn’t make it any less true. Plaintiff’s attorney is clearly most interested in the public relations aspect of this case.”

None of those responses should give Legal Counsel heartburn. All are much better than a cowardly “no comment.”
There’s almost always something better to say than “no comment” or not responding at all.
Thanks for reading.

A Thought about Crisis Communications, 12/24/23
There’s a simple truth in public relations: There are two types of healthcare organizations when it comes to crisis communications. Those that have been hit with one or more reputation-defining crises. And those that will.
And there’s a two-pronged approach to crisis avoidance/management. On the one hand, you do everything within reason (and more) to bullet-proof your organization operationally—from redundant systems to vet new employees, monitor quality, respond to patient and caregiver complaints, maintain secure computer systems, and on, and on (the list seems to grow every year).
Once a provider has done all the right things to identify and resolve threat-level problems, there’s often little desire left to get ready from a communications standpoint. I’ve seen it too many times throughout my career.
One of the ways to prepare for crisis communications is to maintain an active issues management program. Reading Hospice News Today and continuing that work by reading Hospice & Palliative Care Today starting January 1 is a great way to build that early warning system.
At the same time, you should be identifying and media training multiple levels of spokespeople, lining up third-party endorsers, while working throughout the year to strengthen your organization’s reputation (Internally and externally).
Activities like these often fall by the wayside. It could be a lack of focus and energy—or an “it-will-never-happen-here” attitude. It could be for lack of a senior-level champion for such work. It could be for lack of the proper staff or the minimal budget necessary to do at least some of this work.
You probably can skate by for years without the proper preparation. And you’ll be fine. Until that crisis ultimately hits.
My first job in healthcare communications was as head of public relations for Jackson Memorial Hospital in Miami—the nation’s second-largest, second-largest hospital. I used to describe my job to colleagues at nice, safe, boring suburban hospitals as not doing healthcare public relations and marketing but rather handling daily crisis communications in a public sector environment.
It’s a lot of the work I plan to continue to doing once I put Hospice News Today to bed in another week.
Thanks for reading.

A Holiday Appreciation, 12/25/23
As I begin my last week of publication of Hospice News Today, I thank you for your continued readership, words of encouragement, occasional pushback, and interesting queries over the years. I know that Hospice News Today has made a difference in the success of so many readers, so many of their employers. And for that I’m simply grateful.
Thank you!

I Hate Acronyms, 12/26/23
If You Value Your Brand, If You Value Compassionate Patient-Family Communications, You Should, Too.
I’m always dumbfounded by the number of hospices—not-for-profit and for-profit alike—that cheapen their brand by referring to themselves by an acronym derived from the first letter of the name of their organization.
There’s a lot of communications theory behind this, but the simple explanation is that not everyone knows the acronym you associate with your brand. Every time you use an acronym instead of your brand name, you lose a branding opportunity with the community you serve.
And when healthcare providers use acronyms (and other jargon), they place barriers between themselves and the patients and families for whom they care. Acronyms put patients and families on the defensive, it reinforces a relationship that says: “We’re the experts. We’ll tell you what you need to know. And don’t bother to bother us with questions or ask for explanations.” For real.
One final point: When in-office staff and executives use acronyms, they unquestionably send a message to the bedside caregivers that acronyms are not only acceptable in communications, they’re actually the preferred way to show you belong, that you’re important. If you’re a new clinical hire and you want to show you belong, the quickest ways to do that is to start dropping acronyms every chance you can.
Acronyms are convenient. No one likes to type out the entire name of an organization (like Hospice News Today). The acronym (HNT) is easier, quicker. You’ll note, however, you’ve never seen me refer to the newsletter as HNT.
Think about it.
Thanks for reading.

How the Sausage is Made (If You’ll Pardon the Decidedly Un-Kosher Analogy), Part I, 12/27/23
Over the years, any number of readers have inquired as to how I manage to produce the daily newsletter with upwards of 5,000-to-6,000 words.
So, as I’m walking out the door (figuratively), I thought it worthwhile to share how the sausage is made.
As I’ve noted before, I’ve done media monitoring my entire 45+-year career in public relations and politics. It’s changed greatly, of course—from actual newspaper clips mailed from a clipping service to on-line news services that appeared as early as 1980 to Google Alerts to email newsletters to newspapers publishing their content online.
The basic challenges, however, have remained consistent over the years:

How to cast searches broad enough net to capture nearly everything of import
How to cast searches that are not so broad as to inundate you with massive amounts of garbage

The operating principle you learn early on is not to lean on any one source for your news monitoring. Google
I use 150+ keyword searches across multiple platforms – both free (e.g., Google and others) and paid-subscription news databases. I also subscribe to several hundred newspapers, newsletters trade publications, business journals, magazines, etc.—both free and paid subscriptions; both digital and hardcopy formats. These services typically yield 1000+ articles daily that I review and aggregate to the 25 or so articles you see in each issue of Hospice News Today.
As you can imagine, it takes hours to sort through all of that seven days a week.
And, to answer the question I’m asked most often: It’s just me doing the reading, sorting, editing, publishing.
More tomorrow ...
Thanks for reading.

How the Sausage is Made (If You’ll Pardon the Decidedly Un-Kosher Analogy), Part II, 12/28/23
To continue Wednesday’s note about how Hospice News Today is produced each day ...
The daily production cycle never really ends. As soon as I finish transmitting the morning’s newsletter there are dozens of Alerts and newsletters that have piled into my email inbox. I try to handle the incoming throughout the day and try to prepare the articles as they queue up (sometimes the queue waits until the evening, however).
While the newsletter is mostly complete by mid-evening, by the time I turn on the computer at 4 am there are another 75 or so Alerts and newsletters to review. So that I can transmit the newsletter as soon as possible after 7 am Eastern, I cut off the news queue around 6:30 and anything that comes in after that is saved for the next day’s edition.
And, as for long Holiday weekends, I do hold back a handful of stories over the course of a three- or four-day weekend to ensure I have something to publish every day (failure to do that early on caused me to miss the one day I did not publish—a January 2 when I grabbed no appropriate news on New Year’s Day).
An interesting historical note: I was the first-ever healthcare public relations subscriber to the Nexis database when I was head of public relations for Jackson Memorial Hospital in Miami in 1992. At that time, I used proprietary Nexis software provided on a floppy disc and communicated with the Nexis mainframe using a 2400 baud dial-up modem. Nexis was founded by the Mead Paper Company in Dayton, Ohio, which got the idea in the dark ages of 1980 to make the text of articles from a couple dozen newspapers and wire services available to customers on line (If you remember the first ever commercial email service, CompuServe, they had the same idea). If you search correctly, you can still find articles from the early 1980s in the Nexis database. Although Nexis is now owned by a Dutch company, it still maintains significant operations in its founding city.
To maximize your on-line searching, it’s worth learning how to search using Boolean logic. It sounds complicated, but you can pick up the basics in about a quarter hour. Back in the early days of Nexis, Boolean logic was the only way you could search the database. And, while Google does not advertise the fact, you can use Boolean logic to conduct searches and set up Alerts in Google.
Thanks for reading.

About My Objections to Providers Calling Hospice an “Industry”, 12/29/23
At least before I started posting these “Random Parting Thoughts from Your Editor,” the Editor’s comment that always elicited the greatest reaction over the years was—no surprise—this:

[Editor’s Note: Use of the term “industry” in describing the hospice field is counter to the positive image the hospice community has sought to build and nurture over 40 years.]

I recall a particularly heated email conversation several years ago with the relatively new VP of Sales for a legacy not-for-profit hospice provider in a highly competitive market who insisted—vehemently—that not only was there absolutely nothing wrong with calling hospice an “industry,” but that hospices (including his not-for-profit employer) should be widely promoting the notion of a “hospice industry.” We eventually agreed to disagree. But it’s worth noting this VP did not last long in that job directing sales for a highly regarded not-for-profit provider.

Some Background
My passion on this issue stems from my days doing hospital public relations and communications in the early and mid 1990s. At that time the American Hospital Association launched an impressive , six-figure survey research project. Over the course of three years, the association conducted an extensive quantitative and qualitative research program in 33 states. The quantitative portion of the research involved 1,000 phone surveys with a representative sample of consumers in each of the 33 states; the qualitative portion of the research involved a minimum of two focus groups per state (and more in the more populous states).
There were some powerful results from that substantive project. From the research, the association concluded that the most important branding symbol for America’s hospitals was that square blue and white sign with the capital “H” on highways that points you to a nearby hospital. Focus group respondents told surveyors that they knew if they followed that sign they would end up in a place where they would be safe, cared for, and dealt with compassionately. That research was also the first (subsequently confirmed by pollsters like Gallop) to find that the most trusted position in healthcare was a nurse (not a physician. Sorry, docs.). And, at a time when hospitals were just beginning to re-brand themselves as “systems,” the research said that consumers very definitely did NOT want to be cared for by a “healthcare system.” Good timing. I, in fact, ended up going to work soon thereafter for an acute care provider that just a year earlier had spent $1 million-plus re-branding from being a “memorial hospital” to a “health system.” Oye!
But what the American Hospital Association also gleaned from the survey results was that it was just plain bad, stupid, and counter-productive for hospital leaders to talk about a “hospital industry.” The edict went out to every hospital leader and communicator to refer to the hospital “field” or “sector.” This came at a time when the “hospital industry” was approximately 80 percent not-for-profit and 20 percent for-profit (using the simple metric of number of hospitals not licensed beds, patients served, or revenues).
The hospital association maintained its discipline on this verbiage (quite effectively and forcefully) throughout the tenure of the long-serving CEO and his head of communications at the time.
At about the same time, the powers that be in the hospice world stop talking about a “hospice community” or “hospice movement” and instead began talking about a “hospice industry.”
Why? Was it the early incursion of then-small numbers of for-profit providers? Perhaps. I think it was more a function of the fact that the leaders of the hospice movement had become weary of being seated at the children’s table when it came time to divvy up the Medicare pie and some thought that by elevating hospice to the status of an “industry” they could grab a seat at the grown-ups table.
That’s my opinion based on 30 years in healthcare communications. Those senior level hospice administrators who were around in the mid-1990s certainly may choose to disagree.

Why Do I Hate the Term “Hospice Industry”?
For a lot of reasons. For example:

At a time when not-for-profit hospices are desperately trying to differentiate themselves from for-profit hospices, why would a not-for-profit provider want to utilize terminology generally associated with the for-profit sector?
At a time when for-profit hospices are keen to fuzz the differences between for-profit and not-for-profit hospices, why would a for-profit provider want to utilize terminology that underscores the notion of for-profit hospice care?
Skilled nursing calls itself an industry. Is that the standard to which we want to hold hospice?
Is there a physician industry? A primary care industry? A surgical industry? Why must there be a hospice industry?

Finally, try this experiment: Imagine you’re in a consumer focus group and the moderator asks: What’s the first word that comes to mind when you hear the word “industry”? Autos? Energy? Steel manufacturing? Transportation? If you’re in the South, perhaps some will offer textiles or rugs or furniture. If you’re on the coasts, perhaps some will say fisheries and sea food. In the Midwest and Great Plains you might hear agriculture, livestock, or meat packing. In many areas you also might hear tourism. But hospice? I think not.
We started out as a “hospice movement” and evolved to be a “hospice community.” When speaking of the business side, we are the “hospice sector” or the “hospice field.” Hard stop (at least for me and in what I counsel my communications clients).
The word “industry” connotes something far different from the image of a mission-driven healthcare provider—particularly but not exclusively if you’re a not-for-profit provider.
As always, thanks for reading (I know this was a bit long and maybe not so “random”).

A Public Policy Suggestion, 12/30/23
With the approach of the New Year, all hospices great and small (not-for-profit and for-profit) once again must comply with the requirement that five percent of all care be provided by volunteers. Which reminds me of a conversation of about a dozen years ago ...
A hospice pioneer asked me: “If you could change anything about the hospice benefit, what would it be?”
Without hesitation, I replied: “Get rid of the five percent volunteer requirement.”
I was dead serious.
Crazy? Hear me out.
Not-for-profit hospices would continue to meet or exceed the five percent threshold because volunteer involvement is simply part of their DNA. Volun/teers help lower their overall personnel costs. The work their volunteers do with patients often is essential to mission-fulfillment activities that go above and beyond the minimal requirements in the CoPs (like pet therapy, We Honor Veterans, death vigils, etc.). Volunteering is a logical step for many survivors on their personal grief journey. Reliance on a substantial volunteer program is essential to brand identity and community awareness of legacy providers.
For-profit hospices that take their hospice work seriously and responsibly will continue to utilize volunteers. Volunteers lower their cost structures, too. Volunteers often enable them to offer services that go above and beyond the CoPs, which allow the for-profits to present themselves as mission-driven organizations (that just happen to be something other than a 501(c)(3)). Volunteers help strengthen a for-profit’s ties to the local communities served.
And what about the less-than-honorable for-profit providers? What about the owners who salivate at the prospect of being able to wipe out that Volunteer Coordinator FTE? What about the fly-by-night providers whose schemes have been exposed in recent years by journalists at Pro Publica, the Los Angeles Times, and others? Well, they’re not complying with the regulation now—although they’re not being held accountable by regulators for that failure (or for fake documentation). And they certainly won’t rush to employ volunteers should the regulation ever go away.
So ... where’s the harm?
Good hospices (regardless of ownership status) will continue to differentiate themselves by creatively and constructively employing community-based volunteers. Bad hospices will no longer have to fake it.
If the regulation were to go away, I believe a hospice’s volunteer program could become an even more significant differentiator than it is today.
Think about it.
And, on this penultimate day of publication of Hospice News Today, thanks again for reading ...

A Final Parting Thought (Finally!), 12/31/23
Thank You!
For subscribing to Hospice News Today. For caring about issues management and scanning the environment across the post-acute sector. For looking beyond your own silo at the broader world. For believing that Hospice News Today can make you a better provider tomorrow than you are today. For tolerating my occasional snarky editor’s notes.
And for walking each year with 1.7+ million individuals and their loved ones on life’s final journey.
I appreciate every one of you.
And be assured that you’ll be in good hands—starting tomorrow—as Publisher Cordt Kassner and Editor Joy Berger formally launch Hospice & Palliative Care Today. Like everything in hospice, it will be a unique journey. Your readership and feedback will help guide Cordt & Joy in their vital work.
While I’m stepping back from Hospice News Today, I’m not retiring from the hospice movement. I’ll continue to work with hospice providers and vendors to sharpen their strategic communications/messaging, public relations, and marketing communications programs. And would love to hear from you should you ever have a need for those services.
With sincere appreciation and kind regards always,
Mark Cohen