A majority of hospices recently had at least one deficiency in the quality of care they provide, according to a recent audit by the federal government’s top watchdog agency. 

The most common types of deficiencies involved poor care planning, mismanagement of aide services, and inadequate assessments of beneficiaries.

More than 300 hospices had at least one serious deficiency in 2016, representing 18% of all hospices surveyed nationwide in 2016, the Department of Health and Human Services’ Office of Inspector General said in a report this week.

OIG’s concern around hospices is twofold: One, poor quality, and two, rising costs. In 2017, Medicare spent $17.8 billion for hospice care for nearly 1.5 million beneficiaries. That’s up from $9.2 billion for less than 1 million beneficiaries in 2006.

Plus, there’s little Centers for Medicare & Medicaid Services enforcement in hospices, the report complained.

“In contrast, CMS has a variety of enforcement actions available for other types of Medicare providers, such as nursing homes and home health agencies,” it said. Like other Compare websites, CMS should provide individual survey reports on Hospice Compare, it said.

The report also recommended that CMS should:

  1. Analyze claims data to inform the survey process 

2. Analyze the deficiency data to inform the survey process 

3. Seek statutory authority to establish additional, intermediate remedies for poor hospice performance 

4. Include on Hospice Compare deficiency data from surveys, including information about complaints filed and resulting deficiencies