CMS to Delay Hospice Compare Data on ‘Imminent Death’ Quality Measure

Citing a need for further testing, the U.S. Centers for Medicare & Medicaid Services (CMS) will not release Hospice Compare data on hospice visits during the last seven days of life as expected this summer.

CMS uses Hospice Compare to publicly report hospice provider performance on quality measures.Referring organizations such as hospitals and nursing homes, as well as patients and families, are paying increasing attention to these scores when choosing a hospice.

“When choosing a hospice to partner with I would be looking at quality scores, patient satisfaction scores, and responsiveness,” said Michael Ferris, advisor for the hospice and home health consulting firm Healthcare Strategica. “I would look at any available public information about quality.”


CMS requires hospice providers to submit data for two measures pertaining to the number of hospice visits a patient receives when death is imminent:

  1. The three-day measure assesses the percentage of patients receiving at least one visit from a registered nurse, physician, nurse practitioner, or physician assistant in the last three days of life.
  2.   The seven-day measure assesses the percentage of patients receiving at least two visits from a social worker, chaplain or spiritual counselor, licensed practical nurse, or hospice aide in the last seven days of life.

CMS indicated that several months of comprehensive testing was needed to evaluate the seven-day measure’s validity and reliability. The agency said that if testing were to result in substantial changes to the measure, it would submit a new rules for public comment.

“Visits in the last week of life are critical for the patient and their family, and the hospice team can provide care and comfort from many different disciplines,” Judi Lund Person, M.P.H., C.H.C., vice president, Regulatory and Compliance, National Hospice and Palliative Care Organization (NHPCO), said in response to the announcement. “NHPCO is pleased that CMS is taking the time to do further testing.”


The agency said it would still release scores for the three-day measure this summer as scheduled, indicating that the measure meets CMS reporting readiness requirements. This raised some questions from some industry stakeholders.

The National Association for Home Care & Hospice (NAHC) said it would ask for more details from CMS about the agency’s decision to release the three-day portion of the data rather than holding both measures until all testing was complete.

“It’s always been our expectation that these measures would be reported together in order to ensure that the public and hospice providers have a more comprehensive view of the care that’s being delivered,” a NAHC spokesperson told Hospice News.

Though seven-day measure data will not be publicly reported, CMS continues to require hospice providers to submit the data, which are included in certification and survey reports not available to the public.