Hospice Care Index Introduction

When the time comes for hospice care, choosing a trusted, ethical and patient-centered hospice care provider is a choice—your choice. A new consumer hospice care provider tool called the Hospice Care Index (HCI) captures hospice care processes occurring throughout the hospice stay, between admission and discharge. The score of all hospice care providers nationwide is available to those seeking insight to compassionate hospice care available to them in their area. With a score of 10 out of 10, Paradigm Health is committed to working every day to provide exceptional care for patients and their families. Our upcoming series shares how hospice care is measured and what the HCI means for patients and families as they search for a caregiving partner.

Read Part 1 of our HCI series.

What is the criteria for the Hospice Care Index scoring?

At Paradigm Health, we have always been committed to above and beyond care. Making sure a patient has opportunity to identify unique goals of care throughout the hospice care journey is always a priority. Recently, a specific set of criteria was established called the Hospice Care Index that looks at 10 set measurements that consumers can use to determine which hospice care provider is right for them. The categories for measurement include: 

  1. Continuous Home Care (CHC) or General Inpatient (GIP) Provided — A hospice care provider is required to provide all levels of care and provide that care continuously throughout the hospice journey wherever the patient calls home.  
  2. Gaps in Skilled Nursing Visits — A review of submitted claims throughout the hospice care journey will identify if a caregiving gap of more than seven days existed so that a regular pattern of visits is established and adhered to. 
  3. Early Live Discharges —This measurement gages whether a patient came on hospice care service and was then discharged within the first seven days of service. This indicator shows that when a hospice care provider team member comes out to see your loved one, the provider should be making sure that the patient is of hospice mindset, and it is their choice to come on hospice and they understand what hospice is going to be like.  
  4. Late Live Discharges — These discharges are patients who have been on service for six months or greater and have a reason to live-discharge. This may be that the patient is no longer eligible for hospice care or for some reason the patient wants to come off hospice service. A trusted provider should be diligent in placing only the appropriate patients on hospice care and then providing appropriate care on a regular basis.  
  5. Burdensome Transitions (Type 1) – Live Discharges from Hospice Followed by Hospitalization and Subsequent Hospice Readmission. This measurement looks at the live discharges and at patients who revoke or discharge from hospice and go to a hospital, and then once released from the hospital, go right back on hospice. A hospice provide should be able to keep the patient comfortable and provide good education while the patient is on hospice service so that they aren’t returning to the hospital. Communicating with the patient’s family and keeping a steady open line of communication to assess the patient’s status is crucial.  
  6. Burdensome Transitions (Type 2) – Live Discharges from Hospice Followed by Hospitalization with the Patient Dying in the Hospital. This measurement identifies hospice patients who pass away in the hospital setting after being on hospice care. Once a hospice care provider has taken on a patient for care, they should be able to take care of that person without having them have a need to receive are somewhere else.  
  7. Per-beneficiary Medicare Spending — Providers should not be using Medicare dollars beyond what is expected and covered and should not incur extra spending to deliver hospice care.  
  8. Skilled Nursing Care Minutes per Routine Home Care (RHC) Day — This measurement identifies the nursing routine care minutes per day. Trusted hospice care partners are providing good care giving patients an appropriate amount of care regularly and when needed.  
  9. Skilled Nursing Minutes on Weekends — Identifying whether a hospice care provider has a team available during the weekend hours is crucial to avoiding burdensome transitions and keeping peace of mind for patients and families that there will not be a gap in visits. 
  10. Visits Near Death — This measurement reviews the number of visit during the last two to three days of life making sure that the hospice care team has identified when end-of-life is near and providing care appropriate to those final days.