Catholic Hospice executive director retires after 40 years in healthcare management

By Priscilla Greear - Florida Catholic

MIAMI | Dian Backoff retired in December 2024 as executive director of Catholic Hospice, having more than doubled the daily patient census in six years and extended its mission of compassionate end-of-life medical care across the boundaries of the Archdiocese of Miami. Her career spanned 40 years, from nurse to vice president and hospice pioneer—never forgetting the impact of daily nursing care to a woman with amyotrophic lateral sclerosis, ALS disease.

Established in 1988, Catholic Hospice is part of Catholic Health Services (CHS) and serves individuals across Miami-Dade and Broward counties with a life expectancy of six months or less to provide comfort, palliative care and myriad support services. When Backoff arrived in 2018, she implemented service agreements to better respond to the needs of each patient and family.

“How quickly do our families want us to be at the bedside when they have a problem at home? How quickly can we recruit so that we have the appropriate amount of staff? We needed to give ourselves some of those goals and agreements internally, and then we needed to figure out how to set up those programs so that we were meeting those expectations,” Backoff said. “We’ve rated fairly high, so I think that’s led to good care, repeat business and repeat referrals.”

Backoff appreciates the dedicated team who worked to reach goals and make the best decisions for patients, resulting in an increase in the daily patient census from 430 to 910. “I found people here to be very committed to what they were doing. That was very refreshing, and they were also very quick to accept the mission of quality that we have to (continually) increase our quality to grow,” she said. “I think I’m leaving them in a place that’s really positive. They’re positioned for further success and further growth. We have things in place that will keep the organization running. Obviously, they’re going to have to continue to think about optimization as the world of technology grows.”

Backoff, 65, likes to remind staff to remember their “why” to help patients experience a peaceful death. Additionally, “their families can experience what we call a good death and not have complicated grief afterwards and not be so distraught that they’re not healthy mentally,” she said.

On Dec. 20, 2024, leadership and staff from Catholic Hospice, Catholic Health Services (CHS) and Home Health Services gathered for a retirement breakfast to celebrate her leadership and mentorship for continued development. Diana Smith-Lopez, who became executive director on Jan. 1, thanked her and welcomed guests. CHS president and CEO Mary Jo Frick presented a plaque, and many described her as visionary, compassionate, intelligent, fun and inspiring.

CHS’s continuum of care includes rehabilitation hospitals, four skilled nursing centers, two assisted living facilities, home health services, and palliative care. Catholic Hospice gives patients medical supervision, pain management, emotional and spiritual support in their home, assisted living or long-term care facility and at any of CHS inpatient care centers at Holy Cross Health in Ft. Lauderdale; St. Anne’s in Miami; and St. Catherine’s West in Hialeah Gardens. Other hospice services range from music therapy to grief support.

Dr. Tracy Romanello, medical director since 2018, has learned from Backoff’s composure under pressure and respectfulness—plus her ability to commute more than 60 miles daily and still whip up family meals. “She is probably the most levelheaded, calmest person. Under stress, things slow down for her,” she said. “While she’s brilliant, she’s always so approachable that she’ll make you feel like whatever you’re saying is the most important thing she’s going to hear for the day."

Romanello welcomes Catholic Hospice’s growth. “It means we’re providing service to more people in the community, more patients and families,” she said and added “Whether that’s the addition of new staff, or additional resources, she has always provided that and prioritized the needs of others, meaning the patient has always been at the forefront.”

Backoff began her career as a nurse moving into nascent hospice care in the early 80s as Medicare began providing reimbursement. Her first hospice patient was a 54-year-old woman with the debilitating ALS, a fatal type of motor neuron disease, and together they played “Wheel of Fortune” daily at 10:30 a.m. The patient managed to slide tiny letters across an alphabet board. “It was a stressful situation. The only social interaction she got was from the hospice team, and I was one of those people, so I knew that when I walked in, she brightened up. I could see the light in her eyes still, and she was happy to spend that time with me,” Backoff recalls. “It was just the experience of how much help you can be to the patients and families at that time in their life. That made a big impression on me. We were able to help people with all sorts of emotions and clinical symptoms.”

Moving into management, Backoff helped grow VITAS Healthcare from a small hospice operation to the nation’s leading hospice provider, leaving after 27 years as vice president of operations for the Southeast to work with the VITAS founder from 2013-15 in a nonprofit hospice consulting firm. From 2015-18, she commuted weekly from South Florida as a consultant to Visiting Nurse Service of New York before joining Catholic Hospice.

Catholic Hospice is now the only nonprofit hospice in Miami-Dade and one of only two in Broward. With nonprofit she has always striven to make the right decision for the patient beyond financial considerations. “You have to be centered because this business has to run, it has to be viable and sustainable so that you can continue on, and you have to juggle all parts of that, all the things that will keep us growing and relevant in our communities,” she said.

The faith-based nonprofit has three priests and about 10 chaplains available to offer spiritual support to people of diverse backgrounds without bias. “We have a good core of people who are approaching the spiritual complexities of end-of-life care,” said Backoff, a Catholic whose husband is Jewish.

Now Backoff looks forward to more fun in retirement – no work phone on vacations — while continuing to advocate for hospice care and better access, including in rural areas and for the disadvantaged. Looking back, her guiding principle is simple: “Do the right thing at the bedside, and all the other items that you have to work on will fall into place.”

Romanello draws inspiration from Backoff’s abiding dedication. “It’s a true privilege when you get invited into others’ homes at perhaps one of their most fragile times in life.  And I’ve learned so much from being a part of that journey and the transition period,” she said. “It’s a constant reminder to me to live fully.”

Romanello carries forth that growth mindset. “She’s always been thinking about what is next and preparing the team. So, I think that’s where her legacy is that she positioned our organization in the best way possible.”

Sister Elizabeth Worley, archdiocesan chancellor for administration, COO and CHS board member, commended Backoff’s excellent administration. “She has made remarkable progress in the growth of Catholic Hospice and enhanced the services and commitment to the people served in her tenure,” she said. “Catholic Hospice here in Miami has really flourished, and it’s consistent with our mission of saying we provide care through the natural length of life.”

Backoff “understands how to deliver quality programs and has coached her staff to excellence. Everything they do is top notch and that’s why the business has grown so well. She’s gotten the word out to everybody that Catholic Hospice is available if you need hospice services, and it has become one of the premier programs within the boundaries of the archdiocese,” said Sister Worley.