As promised, the first 50 hospices to be chosen for scrutiny and participation in the CMS Special Focus Program have been named. There were no surprises as states that have recently come under scrutiny are well represented including California (14 programs), Texas (10 programs) and a respectable showing for the state of Georgia (5 programs). What does this mean?
Hospices that have been identified as having to participate in this program will be required to undergo more frequent survey (every 6 months), will lose deemed status with accrediting agencies and face potential consequences up to and including provider termination. As we discussed in our blog titled “SFP: The Hospice Lottery that No One Wants to Win”, these 50 hospices were chosen based on an algorithm that included three years of data from:
- (HCI) Hospice Care Index
- Four measures from the (CAHPS) Consumer Assessment of Healthcare Providers & Systems survey
- Conditional Level Deficiencies (CLDs) and Substantiated Complaints on survey over the previous three years.
The chosen cohort agencies can be found at: https://www.cms.gov/files/document/hospice-sfp-2025-cohort-50-selectees.xlsx
What to Do if You Have Been Selected?
Successful surveys are the key to getting out of SFP jail, but that will not be enough. In order to qualify for this program, the hospice has to be in the lowest performing group for the whole country. Survey may be part of it, but ultimately, clinical quality, complaints, perception of care and overall operations are likely what is driving the lower scores and survey problems.
Hospice Support Specialists consultants recommend that if you have been chosen, do not wait a minute to begin your corrective action plan. There are three actions that you should immediately respond with:
- Hire a third party to complete a 360-program assessment to identify risk, operational and clinical program flaws and compliance concerns.
- Develop a solid corrective action plan based on your program assessment and build in timelines, accountability and clearly defined steps to fix your issues.
- Set up a team to own these corrections, meet weekly to report on progress.
Ultimately, if you have landed in this program, you definitely need some assistance. Whether your leadership team is seasoned or new, the only reason you would be in SFP is that something is not working. The only way to ensure that you are making the necessary changes and identifying the root cause of any programmatic problems is to step back and get an objective opinion.
There is Some Good News
Yes, there is good news for those who were selected. What could be good about being targeted as a poorly performing organization? Well, being in SFP gives you the platform to drive new ways of working, to implement better ways to serve patients and families and a common ground to get your whole team on board with excellence in patient care. You have the opportunity to make sweeping changes that, if done correctly, will not only improve patient care and outcomes, but will lead to growth and an enhanced reputation.
Where Should We Start?
We recommend that you hire the right consultant team to support your program. Interview different hospice industry specific experts and find the team that is going to work best with your program in your unique environment. Don’t just choose the cheapest option, choose the company that will be dedicated to serving you well, but will also be honest and scrutinize your program. Remember, if you could do this without expert help, you would probably not be in this place (sorry, but that is just the reality of this).
Next, review your results and scores, review your data and review all of your processes. Work with your consultant team to define a plan of correction for outlying areas. Contract someone to complete a 360-program assessment/survey that will identify ALL your risks. Engage experts who will roll up their sleeves and help get the necessary work done to correct your problems while empowering your team to continue implanting changes over time. Even if you were not selected, if you fall into the bottom ten percent, there are critical changes that you will want to make to ensure the future success of your hospice.
Hospice Support Specialists is a team of hospice experts who are equipped and prepared to help your program implement essential processes to ensure you can succeed. Connect with us today to schedule a complementary exploration call.
