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The soon-to-be-implemented hospice Special Focus Program (SFP) from the U.S. The Alliance was formed by the merger this year of the National Hospice and Palliative Care Organization and the National Association for Home Health & Hospice. “We The program, set to begin Jan. Department of Health and Human Services (HHS).
Hospices coast-to-coast have undergone leadership transitions, including changes in legal executives and a slew of newly appointed CEOs, among other roles in the industry. Texas-based New Day provides home health, hospice, palliative and personal care services across 31 locations in Illinois, Kansas, Missouri and in its home state.
Centers for Medicare & Medicaid Services has made public its first cohort for the hospice Special Focus Program (SFP). Finalized in the 2024 home health payment rule, the program is designed to identify poor performing hospices, mandate quality improvement and in some cases impose additional penalties. million annually.
Beth Van Duyne (R-Texas) and Jimmy Panetta (D-California) have introduced a bill that would reform aspects of the hospice Special Focus Program (SFP). If enacted, the Enhancing Hospice Oversight and Transparency Act also would increase the penalty for hospices that do not report quality measure data to 10% by 2027, up from 4% currently.
Quality, compliance and financial stability are top of mind in hospice merger and acquisitions (M&A) as this year comes to an end. Growing demand is among the constants driving investor interest in the hospice space, according to Tom Lillis, partner at the Kentucky-based firm Stoneridge Partners Strategic Consulting.
Centers for Medicare & Medicaid Services (CMS) has not responded to congressional concerns about the hospice Special Focus Program (SFP). Set for 2025 implementation, the SFP promises to identify hospices delivering poor quality care and target them for improvement remedies. Van Duyne told Hospice News in an email.
New executives have stepped into c-suite and other roles at some of the nations largest hospice organizations as 2025 kicks off. Johnson will oversee the work of Empaths several foundations Suncoast Hospice Foundation, Tidewell Foundation, Hospice of Marion County Foundation and Trustbridge Hospice Foundation.
Regulators have been zeroing in on longer lengths of stay in hospice, but patients with dementia may be caught in the crossfire. . Two policy changes have corresponded with reductions in hospice enrollment among dementia patients, a new study in the Journal of the American Medical Association has found.
Though the numbers are still relatively low, spending on early palliative care rose between 2010 and 2019 for patients with advanced cancers, a recent study found. The increase was associated with earlier palliative care referrals and providers having a hospice and palliative specialist on staff.
The families of patients who received care from nonprofit hospices give their providers higher marks on quality than those who went with for-profits, a RAND Corp. These findings are particularly pressing given the striking growth of for-profit hospices, which have profit incentives that have been shown to affect how they care for patients.”
The company projected evolving hospice industry dynamics over the next year. Texas-headquartered Addus provides personal care, home health and hospice services in 23 states. Addus has taken a more conservative strategic approach, joining the pool of hospice providers scaling back on large purchases.
Cameron Muir has been named as the new CMO of the National Partnership for Healthcare and Hospice Innovation (NPHI). His new title signals the organization’s strategic plans to reshape hospice care delivery through patient-centered, innovative approaches, according to NPHI CEO Tom Koutsoumpas.
AccentCare is primed for further hospice growth, with both health system joint ventures and de novo activity as twin cornerstones of its strategy. Dallas-headquartered AccentCare provides hospice, home health, personal and palliative care across 32 states and in the District of Columbia.
Croix Hospice has cut the ribbon for a new location in La Crosse, Wisconsin. Croix Hospices 18th location in Wisconsin. of Wisconsins overall population during 2019, according to the U.S. Croix Hospice continues to have its eye on expansion. Croix Hospice opened new locations in Missouri, Kansas, Iowa and Wisconsin.
Centers for Medicare & Medicaid Services will end the hospice component of the value-based insurance design model (VBID) as of Dec. Often called the “hospice carve-in,” the program was designed to test coverage of hospice care through Medicare Advantage, in addition to some coverage of palliative care and transitional care.
The two lawmakers, along with others, also brought forth a second bill designed to ensure that hospice patients who need blood transfusions can receive them. Rosen and Murkowski, initially tried to pass the palliative care training bill in 2019, and then again 2021. Jacky Rosen (D-Nev.) Established in 1972, NHSC is part of the U.S.
Centers for Medicare & Medicaid Services (CMS) has reiterated that the agency will not allow hospices to recertify patients after the COVID-19 public health emergency expires. . Face-to-face encounters for purposes of patient recertification for the Medicare hospice benefit can now be conducted via telehealth (i.e.,
Hospice providers will be looking to Congress in 2024 to address issues related to program integrity, quality improvement and industry-wide workforce pressures. As legislative efforts develop, hospices may want to focus their attention on a few key legislators. We don’t have confidence in the algorithm that they proposed.
Two individuals in California have been arrested for their roles in a $54 million scheme to defraud Medicare for hospice and diagnostic testing. From March 2019 to August 2024, these companies allegedly submitted more than $54 million in fraudulent claims to Medicare for services that were never provided and not needed.
Program integrity issues that have heated up in the hospice space during the past five years reached a boiling point in 2023. Hospice providers have seen an array of increased regulatory oversight in 2023. There is scrutiny on hospice care [that’s] setting the stage for the next phase of what hospice oversight looks like.
The hospice chaplain shortage is reaching a tipping point. As they work to recruit and retain their chaplain labor force, hospices are contending with a barrage of issues that also can impact patient access. More than 7,768 chaplains were employed by hospices nationwide in 2019, according to the Zippia report.
Justice Department has indicted Eduardo Lopez, a former hospice executive and current senior vice president of a private equity firm, for violations of the Sherman Act. Lopez is charged with agreeing to “suppress and eliminate competition” for nursing services between March 2016 and May 2019, the U.S. Justice Department has indicated.
On June 1, LifeTouch Hospice will merge with Arkansas Hospice. Both hospices are owned and operated by the SHARE Foundation, a nonprofit, faith-based organization. The hospice last year served 430 patients in a five-county region of Arkansas. In 2019, LifeTouch was in the red for a similar amount.
Centers for Medicare & Medicaid Services (CMS) has finalized its 2024 home health rule, including the implementation of a hospice Special Focus Program (SFP). The rule also finalizes the proposed “36-month”rule for hospice providers. The requirement mirrors a regulation that has existed for several years for home health agencies.
Calls have grown louder for an overhauled design of the Medicare Hospice Benefit, but the path towards change is riddled with contrasting views over regulation, policy and payment structures. One part of the issue is that hospice reimbursement has not kept pace with evolving patient needs, Grant said.
As federal regulators intensify their focus on hospices, operators may begin seeing an influx of Recovery Audit Contractor (RAC) activity. Kelly Grahovac, general manager ,The Van Halem Group As utilization climbs, so does the amount of dollars CMS spends on hospice care, spurring agencies to step up enforcement in an effort to control costs.
Centers for Medicare & Medicaid Services (CMS) has been gradually implementing changes to the hospice survey process and enforcement remedies, including civil monetary penalties in some instances. The monetary penalties were among seven enforcement remedies introduced through the HOSPICE Act and subsequent CMS rules.
Documentation errors and a fragmented health system pose the greatest risks for adverse drug events among hospices. McPherson also serves on the board of the American Academy of Hospice and Palliative Medicine (AAHPM). They also need to know which side effects are more concerning and should prompt a call to the hospice.”
Hospice transactions are facing a new world of challenges during a time when M&A activity is projected to ramp up after recent lulls. More founders who began their organizations when the Medicare Hospice Benefit was established in the 1980s are reaching retirement.
Croix Hospice recently unveiled data showing how the company leveraged predictive analytics technology to improve quality outcomes. In 2019 the Minnesota-headquartered hospice provider began utilizing a predictive analytics tool from Medalogix. Croix Hospice. Through the predictive analytics data, hospice patients at St.
Private equity firms in the hospice space are adapting their “roll-up” strategies as economic uncertainties persist. While the slowdown applies to all buyers, the decline in private equity transactions is particularly noteworthy because they were among the most aggressive acquirers in the space between 2019 and 2022.
The four largest hospice industry organizations are urging congressional lawmakers to mandate changes to the Special Focus Program (SFP) currently set to begin in 2024. Centers for Medicare & Medicaid Services (CMS) last week issued its 2024 home health payment rule , which contained several hospice provisions.
A hospice physician in California is facing up to a decade in prison after pleading guilty for their involvement in a kickback fraud scheme that bilked Medicare of nearly $30 million. Contreras served as a physician for two Pasadena-based providers, Saint Mariam Hospice Inc. and Arcadia Hospice Provider Inc. Meanwhile, St.
Home health and hospice provider The Pennant Group (NYSE: PNTG) has been fueling expansion with a series of acquisitions and new partnerships. Most recently, The Pennant Group agreed to acquire Signature Healthcare at Home’s hospice and home health assets for a price tag of $80 million. their owners are at retirement age.
A federal judge has sentenced Jesus Virlar-Cadena, formerly a medical director for the Texas-based hospice company Merida Group, to 50 months in prison for his role in a $152 million scheme. The Texas Medical Board suspended his medical license in 2019, when he pleaded guilty to the fraud charges.
Centers for Medicare & Medicaid Services (CMS) is seeking answers from the hospice community — including some around utilization patterns and non-hospice spending. The recently proposed 2024 hospice payment rule contained a 2.8% of hospice days and 93.7% In Fiscal Year 2022, routine home care accounted for 98.8%
(NASDAQ: PNTG) has purchased California-based Ardent Hospice and Palliative Care in the San Diego area for an undisclosed amount. Ardent, which also offers home health care, serves between 20 and 50 hospice patients per day, according to National Hospice Locator. Hospice utilization reached 46.1% million, up 5.4%
Gavin Newsom (D) recently approved legislation that expands upon last years’ moves to strengthen hospice oversight in the state, among other enforcement actions. The bills — Senate Bill 664 and Assembly Bill 1280 — followed a Los Angeles Times investigation into alleged misconduct among hospice providers statewide. California Gov.
Patients with dementia are less likely to receive hospice in their last month of life than those who have other diagnoses, 12.5% The Medicare Hospice Benefit initially was designed around the needs of cancer patients, but now the number of patients with other diagnoses is growing — some with less predictable disease patterns.
Prior to joining Optum, Conway was president and CEO of the insurance company BlueCross BlueShield of North Carolina until 2019. UnitedHealth Group, through its subsidiary Optum, is among the largest hospice providers in the nation by Medicare claims, according to research by Hospice News and the data analysis firm Hospice Analytics.
Wages for hospice clinicians continue to go up amid widespread staff shortages, but they grew at a slower rate in 2023 compared to the prior year. Nationally, hourly wages for hospice RNs reached $38.08 In addition to the base wage increases, a majority of hospice providers continue to offer bonuses.
The hospice and senior care provider Helios Care is partnering with the integrated health system Bassett Healthcare Network to bring more extensive access to hospice and palliative care to patients in central New York. Formerly known as Catskills Area Hospice and Palliative Care, the organization rebranded as Helios in 2019.
share in 2019. Published annually at the end of the year, the analysis does not specifically call out hospice expenditures. It nonetheless offers insight into macro-level health care spending trends that hospice operators may find interesting. Hospice providers were not major sources of those expenditures.
While the availability of palliative care is improving, fewer than 5% of patients with serious illnesses who stand to benefit from palliative care actually receive it, according to a May 2019 report by the National Academy of State Health Policy. Some members of the hospice community applauded the senators’ call for change.
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