The Office of Inspector General (OIG) has found Medicare reimbursed hospices do not always offer needed services to beneficiaries and provide poor quality care. To promote compliance and quality of care, the Centers for Medicare & Medicaid Services (CMS) relies on State agencies and accrediting organizations to survey hospices. Surveyors review clinical records, visit patients, and cite hospices with deficiencies when not meeting Medicare requirements. Hospice programs are surveyed at least once every 3 years. Surveyors also investigate complaints. The OIG report provides a first-time look at hospice deficiencies nation-wide in that it includes both hospices that were surveyed by State agencies and those surveyed by accrediting organizations. This report is the first in a two-part series
This study came from an analysis of CMS’s deficiency and complaint data from 2012 through 2016. Data from State agencies and accrediting organizations were analyzed. OIG found a purposive sample of 50 serious deficiencies.