Hospice care is deeply personal, involving tailored support for patients and families during one of the most sensitive times of life. To ensure that hospices provide the highest quality of care and adhere to regulatory standards, surveys play a crucial role in evaluating service delivery. However, for these surveys to be meaningful, it's essential to select a representative sample of patients from diverse care settings. This selection process relies heavily on the careful documentation and detailed patient information that guide surveyors in their work. In this article, we’ll explore the documents and information necessary for proper sample selection in hospice care surveys and why they’re so important.
Key Documents Used for Representative Sample Selection
To ensure that the survey sample reflects the diverse patient population served by a hospice, several documents are used to identify the most appropriate candidates for review. These documents contain vital details about the patients, their care settings, and the services they receive. Here's a breakdown of the documents that play a role in the sample selection process:
Confirmed List of All Multiple Locations (Form CMS-417)
The Form CMS-417 is an essential document that outlines all of the hospice’s multiple locations. This document helps surveyors understand where care is being provided across the hospice’s network. Since some hospices operate across various locations (such as in private homes, nursing facilities, or inpatient care settings), having a confirmed list ensures that all relevant locations are considered in the sample. By including patients from different settings, surveyors can gain a more complete picture of the hospice’s overall care quality.
Unduplicated Admissions Data for the Past 12 Months
This document tracks the unduplicated admissions across the entire hospice system—parent agency and all associated locations—over the last 12 months. This list includes data for all payer sources, giving surveyors a broad understanding of the patients served by the hospice. The goal here is to avoid double-counting patients who may be receiving care in multiple settings during the year. By using this data, surveyors can ensure that the sample reflects the hospice’s full range of care, including both short-term and long-term patients.
Critical Patient Lists for Sample Selection
In addition to the broader organizational documents, there are specific patient lists that surveyors use to choose individuals for the sample. These lists include a wide range of patients from various backgrounds, care settings, and conditions. Here’s a breakdown of the types of patients included:
Active Patients
This list includes patients actively receiving care from the hospice, with details about their location and care type (e.g., at home, in an inpatient facility, or a long-term care facility). For each active patient, the following information is needed:
Patient Name
Date of Hospice Benefit Election
Terminal Diagnosis
Care Setting (private home, SNF, ICF/IID, assisted living, etc.)
Core Services Provided (such as physician services, nursing, medical social services, and counseling)
Non-Core Services (e.g., physical or occupational therapy, speech-language pathology)
Patients on Short-Term Inpatient Stays
Patients who have been admitted to an inpatient facility for pain or symptom management are also included in the sample. These patients often require more intensive care, so their inclusion helps evaluate how well the hospice handles more complex cases.
Patients Who Received Respite Care in the Past Year
Respite care provides temporary relief to family caregivers, allowing them time to rest while the patient receives care in a facility or inpatient setting. Including these patients in the survey ensures that hospice organizations are evaluated on their ability to meet the needs of both the patient and the caregiver.
Patients Who Received Continuous Home Care in the Past Year
For patients receiving continuous home care (CHC), which provides higher-intensity care during a medical crisis, their inclusion in the survey offers insight into how well the hospice can manage critical symptoms at home, avoiding unnecessary hospital admissions.
Patients Who Revoked the Hospice Benefit
This list tracks patients who have revoked the hospice benefit or been discharged from hospice care. Including these patients helps assess whether the care provided led to patient satisfaction and how well the hospice supports families through transitions.
Deceased Patients from the Last 12 Months
A list of deceased patients within the last year is also vital. This helps surveyors evaluate the quality of end-of-life care, including pain management, emotional support, and other essential aspects of hospice services.
Family Members Receiving Bereavement Counseling
Finally, the survey includes family members who have received bereavement counseling after the patient’s death. This ensures that the hospice’s emotional and spiritual support extends beyond the patient to their loved ones, which is a crucial part of the holistic care that hospices provide.
Why This Information Matters
The detailed information provided by these documents is key to selecting a sample that accurately reflects the diversity of patients served by the hospice. The goal is to ensure that surveyors have access to a broad range of cases from various care settings and services. This diversity allows surveyors to evaluate the hospice’s performance across multiple facets of care, including:
Care Quality: How well are patients’ symptoms managed in different settings? Are patients comfortable and receiving the appropriate services?
Service Accessibility: Does the hospice meet the needs of patients in all types of care settings, including private homes, assisted living, and inpatient facilities?
Compliance with Regulations: Are the hospice’s practices in line with regulatory standards for all patient types?
By using these documents to create a well-rounded sample, surveyors can provide hospice organizations with actionable feedback to improve care and ensure they remain compliant with all necessary standards.
Conclusion
Proper documentation and patient information are essential to conducting a comprehensive and representative survey of hospice care services. By ensuring that the sample includes a wide range of patient types—active patients, those in inpatient care, patients who have received respite or continuous home care, and more—hospices can be accurately evaluated for the quality and effectiveness of their services. The use of detailed patient lists and location data helps surveyors assess the full scope of care, ensuring that hospices meet both regulatory requirements and the needs of their patients and families.
Hospices that consistently meet these standards of care are better positioned to deliver compassionate, high-quality services that address both the medical and emotional needs of patients and their loved ones during life’s most difficult moments.
