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Press Release | Advocacy, Hospice, Legislative, Policy

NAHC Applauds Senate Effort to Improve Hospice Survey Process and Increase Transparency

November 7, 2019


Media Contact: Thomas Threlkeld
Director of Communications

NAHC Applauds Senate Effort to Improve Hospice Survey Process and Increase Transparency

Since 1982, the National Association for Home Care & Hospice (NAHC) has been the leading association representing the interests of hospice, home health, and home care providers across the nation, including the home caregiving staff and the patients and families they serve. NAHC and its member organizations are deeply committed to ensuring the highest possible compliance with Medicare and Medicaid participation requirements and delivery of high quality, home-based care. Given this commitment, we greatly appreciate and applaud the work undertaken by Sens. Rob Portman (R-OH) and Ben Cardin (D-MD) in developing the “Hospice Care Improvement Act of 2019”, which is designed to refine the hospice survey process, improve compliance, and increase transparency.

During July 2019 the Department of Health and Human Services’ Office of the Inspector General’s Office of Evaluations and Inspections issued a two-part series examining the overall quality of care provided to hospice beneficiaries and the deficiencies found by surveyors (Hospice Deficiencies Pose Risks to Medicare Beneficiaries (OEI-02-17-00020)), as well as demonstrated existing vulnerabilities relative to preventing and addressing potential harm to hospice patients (Safeguards Must Be Strengthened To Protect Medicare Hospice Beneficiaries From Harm (OEI-02-17-00021)). These reports have made a valuable contribution to the knowledge base surrounding hospice survey performance, and have fostered important discussions between policymakers and the hospice industry on ways to increase transparency related to hospice survey performance, make improvements in the overall hospice survey process, and increase focus/toward providers that perform poorly as evidenced by a history of serious deficiencies and/or substantiated complaints. In response to the reports, NAHC developed a series of recommendations for action by Congress, the Centers for Medicare & Medicaid Services, and the hospice industry that include detailed steps that would:

  • Expand Educational Support and Target Increased Oversight to Foster Hospice Quality of Care
  • Increase Transparency Centered on Survey Performance
  • Provide Additional Patient/Family Support and
  • Improve the Quality and Consistency of the Survey Process

The “Hospice Care Improvement Act of 2019” takes important steps toward addressing the issues identified in the OIG reports by:

  • Addressing the need for greater transparency of survey compliance through:
    • Requiring uniform collection and reporting of hospice survey findings
    • Making survey information publicly available online
    • Including stakeholders in the process of identifying key survey findings that link to quality of care for use in published summaries of survey findings
    • Requiring annual reports on hospice survey performance
  • Making triennial surveys permanent
  • Requiring more frequent surveys for hospices subject to intermediate sanctions and new providers entering the program
  • Requiring state and accrediting organization surveyors to alert hospices to areas of concern at the time a survey concludes, and to provide educational support to assist with improvement on survey performance
  • Development of intermediate sanctions that would include:
    • payment suspension
    • temporary management
    • directed plans of correction
    • mandatory staff in-service training

NAHC is particularly appreciative that Senators Portman and Cardin actively sought input from the hospice community and from other stakeholders in this process. As the legislation receives additional consideration, we look forward to working with members of the Senate and House to advance the best possible solutions for addressing issues raised as part of discussions around the OIG’s findings.

For additional information please contact: NAHC Government Affairs at 202-547-7424