The percentage of beneficiaries receiving at least one visit by a skilled nurse or social worker during the last three days of the patient's life (a visit on the date of death, the date prior to the date of death, or two days prior to the date of death).

The number of decedent beneficiaries receiving a visit by a skilled nurse or social worker for the hospice in the last three days of the beneficiary's life within a reporting period.

Claims-based calculation details: Determine if a beneficiary was in hospice for at least one day during their last three days of life by comparing days of hospice enrolment from hospice claims to their date of death; Identify skilled nursing visits and medical social service visits by the presence of revenue codes 055x (Skilled Nursing) and 056x (Medical Social Services) on the claim (assume that days billed as General Inpatient (GIP) Provided (revenue code 0656) include skilled nursing (i.e., registered nurse (RN) and licensed practical nurse (LPN) visits.). Identify the dates of those visits by the revenue centre date for those revenue codes; Post-mortem visits (signified by the "PM" modifier") are not counted towards the numerator. For each hospice, divide the number of beneficiaries with a skilled nursing or medical social services visit on a hospice claim during the last three days of life by the number of beneficiaries with at least one day of hospice during the last three days of life.

The number of decedent beneficiaries with at least one day of hospice during the last three days of life.

Post-mortem visits (signified by the "PM" modifier") are not counted towards the numerator.

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Data Source: Hospice Medicare claims data. 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. The ten indicators contribute to the HCI score as follows: Each HCI indicator has its own numerator, denominator, and resulting indicator score. A hospice's given indicator score relative to an Index Earned Point Criterion determines whether the hospice earns a point for that indicator towards the full index score; Index Earned Point Criteria were set based on CMS' statistical analysis of national hospice performance to ensure meaningful distinction between hospices; Hospices' HCI scores are calculated as the total number of Index Earned Points across the ten indicators and can range from a perfect 10 to a 0. All hospices with at least 20 claims during the sample period have indicator scores calculated.

Public reporting.

Hospice Care Index Technical Report: www.cms.gov/files/document/hospice-care-index-hci-technical-reportjuly-2022.pdf. Date cited 12/10/23. CMS Current Measures: www.cms.gov/medicare/quality/hospice/current-measures. Date cited 12/10/23.

www.cms.gov/files/document/hqrp-qm-users-manual-v100oct2021.pdf

This measure is linked to the Hospice Care Index (HCI) measure.