Q: You have previously said that hospices in the 21st century need to combine the core hospice philosophy with a “laser-like focus on quality and access to care” — and that hospices always need to be compliant with laws and focused on the needs of patients and caregivers. Where have hospices lagged when it comes to this? In what ways will NHPCO help hospices improve?
 
A: A single instance of poor care is something that every hospice provider and professional wants to avoid. But hospice is largely dependent on volunteers, caregivers and professionals, all of whom are only human. When you serve more than 1.6 million patients and families a year, hospices will sometimes fall short of our collective standards. We need to make sure that we have high standards and that we hold ourselves accountable. We need to practice continuous quality improvement — not simply because it is in a regulation or required by a survey. Having said that, we need to strive to afford our patients and their families the best care that is possible, understanding their goals, and doing what we can to meet those desires. Our goal, shared by our members, is to provide each day of care with a devotion to the highest quality care possible. I want NHPCO to be a resource and accelerator for best practices that will help good hospices become better and lagging hospices to become good. 
 
 
Q: It won’t be too far down the road before a Hospice Compare website and star ratings come to the industry. When are they expected, and what does NHPCO advise hospices to do to prepare for this?
 
A: Hospice Compare will certainly be something new for the hospice community, but I welcome transparency. We look forward to working with CMS to assure that any tool accurately reflects performance. This will not happen overnight, but I agree that if done right this is an important tool that will help consumers make informed decisions. No single tool will capture all of the information that patients and families need to select the hospice that can best meet their needs, but public reporting is one path.
 
 
Q: Many hospices have also had issues with timely filing of NOE/NOTR. Are those issues ongoing or have they been resolved? If those issues are ongoing, what does NHPCO hospices recommend do?
 
A: This issue arose before my tenure at NHPCO, but I am acutely aware of its impact. NOE/NOTR is a perfect example of “no good deed goes unpunished.” However well-intentioned the hospice community was in trying to provide an early warning system for other health care providers when a patient elects hospice (to reduce the likelihood of extraneous payments), the infrastructure at CMS and the MACs just wasn’t ready for the change. And, far too many days of care, provided by hospice programs, were not reimbursed, solely because of administrative mistakes, antiquated systems, or transposed numbers, without an adequate way to correct these types of errors. CMS stepped in and tried to fix some of these issues and we have made progress. But, there are still tens of millions of dollars of unreimbursed care, and we have asked CMS to resolve those glitches the same way they handled them prospectively.
 
Q: A new emergency preparedness CoP is coming in November 2017. What advice/tips is NHPCO offering for hospices about how to prepare for this requirement?
 
A: NHPCO has developed a toolkit for our members to help them with this new CoP. We’ve also helped them prepare in advance with an article in our membership quarterly, NewsLine (that I’m happy to share with your readers), we have done a regulatory podcast available online, and we have scheduled a special webinar on the topic that any provider may register for on April 18. Some of the points we are stressing would be the need for hospices to evaluate their current emergency response plan to see what enhancements must be made to ensure they comply with applicable Federal, state and local emergency preparedness requirements; it’s also important for hospices to map out their process for coordinating and cooperating with local, tribal, regional, state or federal emergency preparedness officials (efforts to reach these officials must be documented); also, hospices must ensure emergency preparedness is incorporated into organizational policies and procedures and these procedures, like the emergency plan, should be reviewed and updated annually.