What are the quality ratings for hospice?

Medicare is intentional to provide open and transparent information about agencies that serve hospice as part of the Medicare benefit.

Agencies must convey the typical conditions they treat and therefore can claim expertise in providing services for end-of-life. Diagnoses that are typically identified for hospice services under Medicare include:

  1. Cancer
  2. Renal Failure
  3. Dementia
  4. Cardiac Disease
  5. HIV/AIDS
  6. Liver Disease
  7. Pulmonary Disease
  8. Neurologic Disease
  9. Stroke or Coma

Medicare requires agencies display where they provide services. This information is different from where they are eligible to provide services. Typical location include: home, assisted living facility, skilled nursing facility, inpatient hospital facility, inpatient hospice facility, or other locations.

Hospice includes 4 levels of care. Those are:

a) Routine home care which is the most common and is provided with the patient is generally stable and symptoms are adequately controlled.

b) General inpatient care is a crisis-like level of care that is implemented for the short-term to support controlling pain and other symptoms. It is usually provided in the hospital or skilled nursing facility.

c) Continuous home care is a crisis-like level of care that is implemented for the short-term to support out of control pain and symptoms in the home setting.

d) Respite care is a temporary care level in a nursing home, hospice facility, or hospital to allow a family member or caregiver some time off. This level of care is not tied to the patient’s symptoms.

Hospice agencies must report what levels of care they engage in to support their patients.

Another rating is the family and caregiver experience. This rating involves the family review of communication, timeliness of services, respect for the patient, providing emotional and spiritual support, help with pain and symptoms, the training provided for the care of the patient, an overall rating, and the willingness to recommend the agency.

Medicare reviews all agency documentation and identifies the completeness of the initial nursing assessment and the visit frequencies from a nurse or social worker in the last 3 days of life. Medicare will also identify if the agency is accepting Medicare, Medicaid, and/or Medicare Advantage patients, as well as report on average how long people access hospice services through the particular agency.

For example, Elite serves both Medicare and Medicaid patients, as well as Medicare Advantage Plan recipients. Patient with Elite’s hospice services are typically receiving hospice for 56 days. The information is updated with Medicare review and state surveys. If you would like to review agencies that you are considering for hospice services, please go to medicare.gov/care-compare/