HJAR Mar/Apr 2023

HOSPICE RATINGS 22 MAR / APR 2023 I  HEALTHCARE JOURNAL OF ARKANSAS   In late January, amid intensifying scru- tiny of the quality of care provided by the American end-of-life care industry, the Cen- ters for Medicare andMedicaid Services has reformed how it inspects hospice providers. The changes, detailed in a 196-page docu- ment, went into effect immediately. Under the new protocol, inspectors must sample data frommultiple locations where the hospice operates and evaluate a broader range of metrics. These include records on the hospice’s inpatient care, bereavement practices and reasons patients are leaving the service alive. “An unusually high rate of live discharges could indicate that a hospice provider is not meeting the needs of patients and families or is admitting patients who do not meet the eligibility criteria,” the revised rules note. The rules also include directives for inspectors to evaluate the abuse and neglect of patients — an issue that has long plagued hospice providers, according to investiga- tions from both the media and the Depart- ment of Health and Human Services Inspec- tor General’s Office. In fact, surveyors are now required to consult news reports, pre- vious complaints and patient reviews about the hospice in question before they begin an inspection. In November, a ProPublica-New Yorker investigation exposed the way easy money and lax regulation have transformed a char- ity movement into a $22 billion juggernaut rife with exploitation. It also described an alarming network of entrepreneurs prop- ping up for-profit hospices in Nevada, Texas, Arizona and California. State and federal licensing data showed that addresses in Phoenix, Houston, Las Vegas and Los Angeles were reportedly home to dozens — sometimes hundreds — of hospice startups, many with the same owners. The overhaul of the inspection require- ments is the most concrete reform to date to emerge from the recent push for and dis- cussion surrounding greater oversight of the American end-of-life care industry. The demands continue to grow. Last week, a bipartisan coalition from the House of Representatives sent a public letter to CMSAdministrator Chiquita Brooks-LaSure calling for a crackdown on fraud and abuse of the hospice benefit. “As you know, ProPublica and The New Yorker published an article on November 28, 2022 detailing horrific allegations of fraud