This year ( April 2007) the Office of the Inspector General (OIG) for the Department of Health and Human Services (HHS) issued a report entitled “Medicare Hospices: Certification and Centers for Medicare & Medicaid Services Oversight.”

The results were from surveys performed by State agencies tracking the extent of the Centers for Medicare & Medicaid Services (CMS) of hospice programs which were receiving Medicare funds.

Here are the highlights of what they found, keep in mind that the most recent data available was from 2005.

14% of the hospices were past due for their certification, and the average number of years they had not been surveyed was 9.

Michigan, Illinois, and California accounted for 41% of all hospices with past due certifications.

In 2005 CMS required hospice certification every 6 years, but changed that number to 8 years in 2006.

Also reported was that health deficiencies were cited for 46% of hospices surveyed and for 26% of hospices investigated for complaints. The most frequent health deficiencies and complaints were regarding patient care planning and quality.

Of those cited during complaint investigation, 49% were repeat offenders.


The recommendations of the OIG to the CMS included:

• Providing guidance regarding analysis of data and identification of at-risk hospices.

• Including hospices in Federal comparative surveys and annual State performance reviews.

• To seek regulatory changes to establish specific requirements for the frequency of hospice certification.

• To seek legislation for enforcement of poor hospice performance.


Currently, the only remedy to a hospice with a poor performance is to dismiss the hospice from further association with the Medicare program. The CMS rejects the regulatory changes citing that hospice certification is a statutory issue for consideration by the Congress.

To read the full OIG report click here to download a copy.