Indicates the hospice provider's proportion of Medicare Fee-for-Service patients who have received in-person visits from a registered nurse (RN) or medical social worker (MSW) on at least two out of the final three days of the patient's life. The object of this measure is to capture the provision of services at the end-of-life. The last few days before death are typically the period in the terminal illness's trajectory with the highest symptom burden.

The number of patient stays in the denominator in which the patient and/or caregiver received at least two days with visits from registered nurses or medical social workers in the final three days of life. Note: Any visits occurring after the time of the patient's death do not count towards the measure score.

All hospice patient stays enrolled in hospice except those meeting exclusion criteria.

The measure is not calculated for hospices with fewer than 20 patients in the denominator. Patient did not expire under hospice care; Patient received any continuous home care, respite care or general inpatient care in the final three days of life; Patient enrolled in hospice less than three days. Patient did not expire in hospice care as indicated by reason for discharge (exclude if the patient discharge status code, PTNTDSCHRGSTUS_CD, does not equal [40, 41, or 42]); Patient received any continuous home care, respite care or general inpatient care in the final three days of life (exclude if revenue codes= [0652, 0655, or 0656]). Not these coded items are CMS-specific.

None

None

Data Source: Hospice claims. Data are obtained from provider submitted claims for the information needed to calculate the measure, so providers do not submit any additional data to CMS. CMS will use 2 years of Medicare claims data (8 quarters) to calculate the measure. CMS will extract the data at least 90 days after the last discharge date in the applicable period and use it for quality measure public reporting on Care Compare. Registered nurse visits are identified by revenue code 055x with the presence of Healthcare Common Procedure Coding System (HCPCS) code G0299. Only RN visits are included. In-person visits from medical social workers are identified by revenue code 056x (other than 0569); Healthcare Common Procedure Coding System (HCPCS) code G0155. If an RN and SW make a visit to the patient/family on the same date, only one of the visits will count towards the measure calculation

Public reporting

National Hospice and Palliative Care Organisation [website]: www.nhpco.org/wp-content/uploads/HVLDL_Resource.pdf. Date cited 11/10/2023. Center for Medicare and Medicaid Services [website]: www.cms.gov/medicare/quality/hospice/current-measures. Dated cited 11/10/2023. www.cms.gov/files/document/current-measuresoct2021.pdf www.cms.gov/files/zip/2021october19hqrp-forum-materials-zip.zip

www.cms.gov/files/document/hqrp-qm-users-manual-v101aug2022.pdf

Linked to NQF measure #3645