CMS Standards and Deficiencies in Hospice

U.S. Department of Health and Human Services Report

The U.S. Department of Health and Human Services released a report this July stating that 80% of hospices surveyed from 2012 to 2016 had at least one deficiency in the quality of care they provided. The most common types of deficiencies were poor care planning, mismanagement of aide services, and inadequate assessments of beneficiaries. There were also deficiencies that posed risks to beneficiaries, such as improperly vetting staff and inadequate quality control.


Conditions of Participation

To participate in Medicare, a hospice must meet Federal requirements called Conditions of Participation (CoPs). The CoPs are standards of health as well as safety that must be met. These requirements are put in place to ensure that proper care is provided to all patients. A survey must be completed once every three years to verify compliance.  


Deficiencies 

If a Federal requirement is not met, the hospice is cited with a deficiency. Deficiencies have two levels, condition level and standard level. A condition level deficiency is more serious, where there is a great risk to patient care and safety. If a deficiency is found, the hospice must send in a plan of correction detailing how the issue will be fixed. 


Deficiencies that are Not Corrected 

If there was a deficiency on the survey which was not addressed appropriately, the hospice will be removed from Medicare.  


Stop Deficiencies Before They Start

One requirement is that you must keep clinical records containing past and current information for each hospice patient. The best way to manage records is with an Electronic Medical Record (EMR). This allows for all documents, plans of care, infection control reports, and assessments to be accessible in one place for the use of hospice staff. 


Elara Hospice EMR

Our EMR Solution is designed to track all aspects of patient care including referral, assessment, discharge, and reporting. Hospice and palliative care specific documentation is included as well as clinical assessment and dynamic visit forms.