A report published by the U.S. Department of Health and Human Services Office of Inspector General (OIG) discusses serious care deficiencies found in hospice services and the shortcomings in federal regulation and oversight to prevent these kinds of harm to beneficiaries.  

The report, Hospice Deficiencies Pose Risks to Medicare Beneficiaries, found that 80% of hospices were cited for at least one deficiency in care and 20% of providers had a serious deficiency during the years 2012-2016. Poor care planning and inadequate staff vetting and training caused most care deficiencies.

The OIG recommended several policy changes:

• CMS should strengthen requirements for hospices to report abuse, neglect and other harm regardless of the perpetrator. Current CMS guidance now requires this only “when it involves someone furnishing services on behalf of the hospice and the hospice has investigated and verified the allegation.”
• Hospices should better educate their staff to recognize potential abuse and neglect.
• CMS should strengthen guidance for state surveyors to report crimes to local law enforcement.
• CMS should improve monitoring of state survey agencies’ citations of immediate jeopardy.
• CMS should make it easier for consumers to get information on hospices through Hospice Compare and should provide better mechanisms for consumers to file complaints through a standard complaint form, publication of state agency phone numbers, and information for hospices to give consumers on their rights and the complaint process.