NAHC Calls for Greater Frequency of Hospice Surveysnce

NAHC Calls for Greater Frequency of Hospice Surveysnce

June 30, 2014 09:30 AM


For additional information:

Barbara D. Woolley
National Association for Home Care & Hospice
(202) 547-7424

Washington, D.C. (June 27, 2014)—Peter Whoriskey’s article (“Infrequent inspections of hospices can lead to agonizing lapses in care,” Washington Post, June 27) brings needed attention to a vital problem that the hospice industry has sought to correct for many years: the infrequency of government reviews (or surveys) to ensure that providers meet stringent patient quality-of-care requirements. The National Association for Home Care & Hospice (NAHC) and its affiliate Hospice Association of America (HAA)have consistently argued for a statutorily set frequency for hospice surveys (as is the case for home health and other Medicare providers). The two organizations call on Congress and the Centers for Medicare & Medicaid Services (CMS) to address this pressing need.

Action on this issue is now particularly critical for several reasons. In 2008, CMS made major changes to the Conditions of Participation under which hospices are surveyed. Yet many hospices — six full years later — have not been reviewed by government surveyors to ensure they are meeting the 2008 requirements. In addition, the hospice industry is undergoing rapid change and being subjected to increasing regulatory requirements, circumstances that make it all the more important for hospices to ensure that they maintain a continuing commitment to minimum care standards.

“The good news is we do know that the vast majority of hospice providers are making every effort to ensure that patient and family needs are being met,” stated NAHC President Val J. Halamandaris, “Under the 2008 Conditions of Participation, hospices must maintain a program that measures the quality of care that they provide. Many hospices, as part of their quality programs, also conduct patient and family satisfaction surveys, among the most effective measures of how well hospices are doing their jobs.”

California-based Strategic Healthcare Programs (SHP), a national hospice benchmarking firm, provides feedback to hospice providers of all types and sizes on an extensive survey questionnaire that’s been designed to determine how well patient and family needs are being met. According to SHP’s aggregate data, the average rating of hospices based on survey findings in key areas are as follow:

  • Attendance to family needs: 94%
  • Provision of information about symptoms: 93%
  • Provision of coordinated care: 93%
  • Provided the right amount of assistance with the patient’s breathing: 94%
  • Treated the patient with respect: 97%
  • Received the proper amount of instruction for the care that family member was providing directly to patient: 96%
  • Provided the right amount of emotional support to family member: 94%
  • Hospice doctors or nurses knew enough about patient’s medical history to provide the best possible care: 95%
  • Overall ranking of patient care as Excellent or Very Good: 92%

As with all health care providers, there are concerns about hospice that must be addressed. Still we believe that more frequent assessment of hospice providers’ success in meeting quality requirements and CMS’s development in recent years of an increasingly robust quality reporting program, will go a long way toward addressing many of the concerns that Mr. Whoriskey has raised.


The National Association for Home Care & Hospice (NAHC) is a nonprofit organization that represents the nation’s 33,000 home care and hospice organizations. NAHC also advocates for the more than two million nurses, therapists, aides and other caregivers employed by such organizations to provide in-home services to some 12 million Americans each year who are infirm, chronically ill, and disabled. Along with its advocacy, NAHC provides information to help its members provide the highest quality of care and is committed to excellence in every respect. To learn more about NAHC, visit


The Hospice Association of America (HAA) is a national organization representing thousands of hospices, caregivers and volunteers who serve terminally ill patients and their families. Recently ranked the most effective health care trade organization on Capitol Hill by congressional offices, HAA advocate the industry’s interests before Congress, the regulatory agencies, other national organizations, the courts, the media, and the public. The association serves hospices that are freestanding and community-based, as well as those affiliated with home care agencies and hospitals. HAA’s members are both Medicare-certified and all-volunteer hospices. HAA is an affiliate of the National Association for Home Care & Hospice. To learn more about HAA, visit