Hospice providers could soon be facing more recertification surveys, if the Department of Health and Human Services Office of Inspector General has any say in it.

About 17% of state-surveyed hospices had not been recertified in six years, according to a new OIG report. In 12 states, the number climbed to more than 25%. The report, which was released Aug. 29, follows up on a similar one conducted in 2005. The results of the earlier survey showed that 14% of state-surveyed hospices had not been recertified in six years.

After that finding, OIG recommended the Centers for Medicare & Medicaid Services set a timeframe for recertifications of about three years. CMS wound up readjusting annual survey frequency targets instead: in 2013, the target was every 6.5 years. This, however, isn’t federally regulated, like nursing home rules, which call for surveying every 15 months.

OIG surveyed more than 2,000 hospice providers, with some states faring worse than others. In California, Idaho and Oklahoma, for example, the percentage of providers that hadn’t been recertified within six years was more than 50%.

CMS has taken some action on more stringent hospice oversight. In August, the agency issued a final rule to enhance quality oversight. Starting July 1, 2014, quality will be measured by a Hospice Item Set with seven measures. On January 1, 2015, CMS also will begin gathering feedback from hospice patients and family members about their experiences and satisfaction with hospice care.

Although these new quality enhancements have been introduced, OIG says that results will not be available for a few years; right now, the investigative agency warns, multiple hospice providers are out of compliance. OIG report authors emphasized the agency’s desire for set recertification time limits.

Click here to read the full report.