Hospice Care Index (HCI)

The Final Rule for hospice 2022  included the retirement of public reporting of seven Hospice Item Set (HIS) measures.  These were replaced with a claims-based composite item called the Hospice Care Index (HCI).  This new item will be publicly reported no sooner than May 2022.  In case you missed it or need a refresher, there are ten items included in the HCI.  Several of the indicators are related to skilled nursing visits.  Specifically, Indicator Two looks at gaps in nursing visit of eight or more days.  Indicator Eight examines the frequency and number of minutes per day spent in the home with the patient by either the RN or LPN/LVN for Routine Home Care. The number of minutes is compared to rankings among hospices nationally.  Similarly, Indicator Nine assesses the number of minutes of skilled nursing visits on weekends for Routine Home Care.  It is also compared to national rankings.  And finally, Indicator Ten measures skilled nursing and/or medical social services visits performed in the last three days of life.  The calculation of this measure is also based upon the hospice’s ranking compared to other hospices nationally.

These and other HCI measures will be published on a CMS website in the near future.  It’s important for hospice organizations to be cognizant of the provision of skilled nursing visits according to the patient and family’s needs.  Moreover, it is vital that services provided, time in the home, and dates of visits are being accurately reported on the hospice claim.