This article is sponsored by ACHC. In this Voices interview, Hospice News sits down with Susan Mills, Senior Program Director for Home Health and Hospice, ACHC, to talk about the key compliance challenges, opportunities and trends to watch in the current hospice environment. She explains how ACHC can help providers navigate the tumultuous regulatory landscape and provides a future outlook on the hospice industry in the years ahead.
Hospice News: What career experiences do you most draw from in your role today?
Susan Mills: I have 30-plus years in the home health and hospice industries and have been with ACHC for the past 14 years. But the quality and regulatory positions I have held at the agency level have given me firsthand exposure to quality management, regulatory compliance and the complexities of implementing and sustaining a culture of quality.
This knowledge has been invaluable when relating to customers who are navigating similar challenges. It has allowed me to relate to their struggles, understand their unique circumstances, and provide practical advice and solutions based on my own experiences and expertise to help customers overcome obstacles, address regulatory requirements, and foster a culture of quality within their agencies.
Tell me about the history of ACHC. How did ACHC become the leader in the home health and hospice accreditation space?
ACHC is a nonprofit organization that was founded in 1986. It was established with the goal of improving the quality of health care services and patient safety through accreditation and certification programs. ACHC initially focused on accrediting home health agencies, but over the years, it has expanded its scope to include other health care sectors such as hospice, hospital, pharmacy, DME, home care and renal dialysis. ACHC is recognized by the Centers for Medicare and Medicaid Services (CMS) as a deeming authority for home health and hospice.
ACHC has become a leader in these spaces through its commitment to quality standards that permit flexibility without compromise, a strong emphasis on customer service, and surveyors with extensive industry expertise in the area they survey. We’ve also recently added accreditation for hospitals which has allowed us to make an even greater impact across the continuum.
What are some of the key hospice industry challenges you’re monitoring today?
The hospice industry, subject to stringent regulations, must navigate frequent changes that can greatly affect providers, including shifts in state and federal laws, reimbursement models, and quality reporting. Equitable access to hospice care is hampered by disparities affecting certain racial, ethnic and socioeconomic groups, posing a challenge that extends to educating patients and families about hospice services, and identifying those with advanced illnesses sooner to maximize the benefits. Achieving smooth coordination between hospice care and other health care settings, such as hospitals and nursing homes, is critical yet complex due to the need for seamless care transitions and clear communication.
The health care industry at large also faces challenges like frequently changing regulations and policies affecting operations and compliance, escalating health care costs straining all stakeholders, and rapid technological advancements including artificial intelligence and telemedicine. Workforce shortages and the need to secure patient data privacy with the growing reliance on electronic health records and digital tools are also making a significant impact across home-based care and hospice.
Can you provide examples of the most frequent compliance struggles for hospice agencies?
Most compliance challenges typically revolve around documentation and adherence to orders. Some of the most common problems are with Aide Services, ensuring that clear written care instructions are provided to the aide and that the aide follows the established plan of care.
Additionally, there are several issues with Patient Record maintenance, which encompasses the accurate and comprehensive documentation of patient assessments, care plans, medication profiles and communication with interdisciplinary teams. Another aspect of compliance is providing care in alignment with the plan of care, and the omission or addition of visits can also lead to deficiencies.
How does ACHC help agencies address these compliance challenges?
ACHC is committed to developing and updating accreditation standards for hospice agencies, ensuring alignment with current regulations and offering clear guidelines for compliance. We provide a range of educational resources and training materials, including workshops, webinars, and workbooks, to assist hospice agencies in understanding and implementing these standards. Additionally, ACHC conducts regular on-site surveys to assess agency compliance, providing feedback on performance and identifying areas for improvement.
What is your outlook on the future of hospice accreditation, and how does ACHC fit into that vision?
The future of hospice accreditation is likely to maintain a focus on increased oversight, ensuring high-quality end-of-life care, patient-centered services, and a focus on greater access to hospice services for those who need it.
ACHC plays a significant role in shaping the future of hospice and home health accreditation by continuously updating its standards and providing programs and services to reflect changes while also meeting the needs of providers. We can additionally provide education and support to providers to help them meet and exceed these standards.
Finish this sentence: “In 2023, the hospice industry has been defined by…”
…increased oversight due to the rapid growth in specific geographic regions as well as staffing issues.
Editor’s Note: This article has been edited for length and clarity.
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].