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Press Release | Hospice, Medicaid, Medicare, Policy

NAHC Statement on Office of Inspector General Report on Hospice

July 9, 2019


Media Contact: Thomas Threlkeld
Director of Communications

NAHC Statement on Office of Inspector General Report on Hospice

The National Association for Home Care & Hospice (NAHC) supports action taken in recent years to increase hospice providers’ accountability for delivery of high-quality care, including through imposition of a mandate for more frequent surveys. However, the finding of the Office of Inspector General (OIG) sends a clear message that more action is required to safeguard vulnerable hospice patients. The Centers for Medicare & Medicaid Services (CMS), states, accrediting organizations, hospice associations, and hospice providers must all address existing gaps in oversight of hospice quality of care so the problems cited in the report are eliminated. NAHC fully agrees that safety of hospice patients cannot be compromised.

While a methodical and comprehensive approach to this issue is clearly warranted, corrective efforts should be tailored (and prioritized) based on the nature of a hospice’s deficiency. The egregious examples of harm discovered by the OIG require an immediate focus on the small number of providers with incidents of jeopardizing patient safety. CMS should employ a variety of methods to address these agencies’ failings, including subjecting them to the closest of scrutiny until they are able to demonstrate the ability to meet quality standards and the conditions of participation on an ongoing basis.

The vast majority of hospice providers are able to meet quality of care standards, but some still fail to meet all the Hospice Conditions of Participation upon survey. It is important to note that virtually all these deficiencies are addressed in short order by hospice providers. However, we believe that some of the OIG’s proposed recommendations may help some providers avoid these issues on the front end, and could contribute to improvements in the overall quality of care provided to hospice patients. NAHC strongly supports the OIG’s recommendation that CMS provide hospices education about common deficiencies and those that pose particular risks to beneficiaries. Historically there has been limited education available to providers in these areas, and information directly from CMS is vital to maintaining a continuing understanding of quality of care requirements. Direct educational offerings also provide a unique opportunity for give and take between CMS and the hospice community around quality and survey issues.

A number of the OIG’s recommendations center on increased public availability of hospice survey data for use by consumers, referring providers and others. It is our understanding that CMS is working to build the capacity of Hospice Compare to incorporate this type of information. NAHC recognizes the value of such transparency and the benefit that this type of information can supply, but strongly believes that such action should only be taken when data from all survey organizations is available for posting, the data is comparable across hospice providers, and the data is displayed in a clear and understandable way.

The OIG’s reports provide all stakeholders an important opportunity to examine ways to create more coherent, consistent, and responsive processes for addressing quality of care under hospice. NAHC looks forward to working with its members to thoroughly examine and respond to the OIG’s recommendations, as well as to work with CMS and other stakeholders to ensure quality care for hospice patients.


About National Association for Home Care & Hospice (NAHC)

The National Association for Home Care & Hospice (NAHC) is the voice of home care and hospice. NAHC represents the nation’s 33,000 home care and hospice providers, along with the more than two million nurses, therapists, and aides they employ. These caregivers provide vital services to Americans who are aged, disabled, and ill. Some 12 million patients depend on home care and hospice providers, who depend on NAHC for the best in advocacy, education, and information. NAHC is a nonprofit organization that helps its members maintain the highest standards of care. To learn more, visit