Providers Approve GAO’s Call for Tougher Hospice Requirements

Posted January 12, 2023

McKnights Home Care

By: Diana Eastabrook

The National Association for Home Care & Hospice praised a recommendation Wednesday by the Government Accounting Office that would require hospice providers to report patient abuse and neglect to the Centers for Medicare & Medicaid Services the same way nursing homes and hospitals do.

Theresa Forster, NAHC vice president for hospice policy, told McKnight’s Home Care Daily Pulse CMS should implement the recommendation immediately.

“Further, ​NAHC ​strongly urge​s​ that, in tandem with the GAO’s recommendation, the Department of Health and Human Services take action to implement  proposals put forth by the Office of the Inspector General during 2019 recommending that hospices be required to develop written policies and procedures for investigating and reporting suspicions of abuse, neglect and other harm, and supply hospices with informational materials to assist them in educating their staff in recognizing signs of abuse, neglect, and other harm to patients under their care,” Forster said in an email.

In a report to CMS, the GAO said hospice agencies should follow the same rules as nursing homes in reporting abuse and neglect, even when it involved “unaffiliated perpetrators.”

Currently, hospice providers are required to report allegations to state agencies monitoring them only if the alleged perpetrator is affiliated with the hospice and after the hospice has verified the abuse or neglect following an investigation. Often an internal investigation can take up to five days. Nursing homes and hospitals, however, must report all abuse and neglect allegations, regardless of whether the alleged perpetrator is affiliated with their agencies and prior to conducting an investigation.

The GAO said reporting allegations prior to an internal investigation is important because state agencies use abuse and neglect allegations to decide whether to perform unannounced on-site investigations. It continued stating that aligning hospice reporting requirements with nursing homes and hospitals will help CMS ensure that hospice providers are taking appropriate steps within the scope of their authority to protect vulnerable patients.

The GAO found gaps in the requirements for hospices, following a review requested by CMS.

The federal government is implementing other new, tougher measures against hospice providers. It is planning to release a report this year on the findings of a Technical Expert Panel regarding a Special Focus Program for poor-performing hospice providers.

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