Marketing your CMS Hospice Compare scores (Part III – Quality Care)

The final part of our series on Marketing your CMS Hospice Compare Scores covers Quality of patient care. These compare scores are based on data gathered through the HIS Comprehensive Assessment Measure.

1. Percentage of patients getting at least one visit from a registered nurse, a physician, a nurse practitioner, or a physician assistant in the last 3 days of life. This measure assesses how the hospice team addressed the needs of the family and patient in the final days of life. Certainly, marketing this score is advisable only if it is above 90%. Families researching hospice agencies for a loved one would want to choose an agency who provides attentive care during the difficult final days of life. A lower score to this query indicates a staffing issue. (National Average 82.3%)

2. Patients who got an assessment of all 7 HIS quality measures at the beginning of hospice care to meet the HIS Comprehensive Assessment Measure requirements. This is a composite score of the 7 HIS measures. (National Average 86.4%)

The Seven Measures that make up the HIS Comprehensive Assessment Measure:

1. Patients or caregivers who were asked about treatment preferences like hospitalization and resuscitation at the beginning of hospice care. A high score here can be achieved by having initial discussions with patients about what they do and do not want at the end of life. (National Average 99.1%)

2. Patients and caregivers who were asked about their beliefs and values at the beginning of hospice care. A high score here can be achieved by giving patients and their family the opportunity to discuss their spiritual and religious beliefs to help ensure these needs are met throughout the dying experience. The patient beliefs can differ from that of the family. It is vitally important to honor the beliefs of the patient and to provide compassionate family mediation.  (National Average 96.6%)

3. Patients who were checked for pain at the beginning of hospice care. Pain is common for hospice patients, and pain management can be difficult for late stage terminal patients. Checking for pain at the beginning of care can provide assigned team members with a gauge to help them stay in front of patient pain and boost scores on this measure.  (National Average 96.8%)

4. Patients who received timely and through pain assessment when pain was identified as a problem. The team should document the pain intensity, location, and duration within 24 hours of discovering that pain has become a problem. (National Average 90.3%)

5. Patients who were checked for shortness of breath at the beginning of hospice care. Shortness of breath is common for terminal patients and can cause distress and anxiety to both patient and caregiver. For optimum care management teams should assess and document patient breathing at the start of hospice care. (National Average 98.2%)

6. Patients who got timely treatment for shortness of breath. Team members should start treatment within 24 hours of discovering that breathing has become a problem. (National Average 96.3%)

7. Patients taking opioid medication who were offered care for constipation. Team members should recommend preventative treatments such as laxatives or fiber enriched diets to avoid opioid-related constipation. (National Average 94.1%)

Reviewing your agency’s compare scores should be a routine part of your continuous improvement program. Superior patient care and satisfaction are both firm foundations to build your business on. Above average scores can translate to referrals, and we offer a referral building tool to highlight them. Visit the TAG Webstore or call us at 866-232-6477 for more information on our Choosing Hospice Flyer for Physicians and take the next step in successful hospice marketing.

Marketing your CMS Hospice Compare scores (Part II – Family experience of care)

Increase your physician referrals by marketing your CMS Hospice Compare Scores. There is an excellent marketing tool available through CMS that many hospice agencies are not utilizing. CMS’s Hospice Compare site provides potential patients and referring physicians with a published track record of how your agency’s performance stacks up to the competition. Physicians want to refer patients to proven hospice providers, so naturally promoting your above average compare scores is an excellent way to boost referrals.

• The Hospice Compare scores are broken down into five categories:

• General Information: Levels of Care

• Conditions

• Location of care

• Family experience of care

• Quality of care

Your agency may not excel in all measures, but you can highlight areas where you do excel and work on the areas where your team is falling behind the national averages.

The Family experience of care section is the important area of the survey where family caregivers of patients who died while under hospice care are asked about their experiences with hospice. These scores can directly affect the success of your agency:

1. Communication with family - This question generally brings a high score by most patients surveyed. A score less than 80% could indicate the need for more interaction from social workers and counselors to help explain the dying experience to overwrought caregivers. (National Average 80%)

2. Getting timely help - Hospice patients can experience agitation, disorientation, and general discomfort which they often cannot articulate to their family caregiver. This can cause severe anxiety for caregivers. An 80% score means your agency is above average in responding to patients and their caregivers. Marketing timeliness is always a good way to increase physician referrals. (National Average is 78%)

3. Treating patient with respect* - This score is a composite percentage of two survey questions: A. Did the team treat the patient with dignity and respect? B. How much to you believe the hospice team really cared about their loved one? A score below 90% to this question is a red flag for your team, not only for potential patients using the hospice compare site, but also for agency administrators. It is an indication of understaffing, overscheduling, and staff performance which is not reflective of the hospice mission. (National average 91%) 

4. Emotional and spiritual support* - This score is a composite percentage of three survey questions: A. How much emotional support was received from the hospice team while their family member was in hospice care? B. How much emotional support they received from the hospice team in the weeks after their family member died? C. How much support they received for their religious or spiritual beliefs? This is a great score to market if your agency recorded a 90% or better. (National Average 90%)

5. Help for pain and symptoms* - Though this percentage is a composite of several questions it is a difficult area of the survey to market as many family members mistake the limitations of medical pain relief with poor pain management. You may want to avoid marketing your results on this question unless you score well above the national average. (National Average 75%)

6. Training family to care for patient* - This is another composite question that focuses mainly on medication education and symptom recognition. A below average score on this question may indicate the need for training modification. (National Average 75%)

7. Rating of this hospice - Family caregivers rate the hospice agency on a scale of 0 – 10. The published score is the percentage of people who rate the agency at 9 or 10. A score less than 80% could indicate the need for a staff review of best practices. (National Average 81%)

8. Willing to recommend this hospice - This score is the yardstick whereby you can measure your agency’s success. Hospice is compassionate care for the dying and their families. If someone is not willing to recommend your agency to help others through this journey, you need to evaluate your staff, your training, and your company mission. (National Average 84%)

Reviewing your agency’s compare scores should be a routine part of your continuous improvement program. Superior patient care and satisfaction are both firm foundations to build your business on. Above average scores can translate to referrals, and we offer a referral building tool to highlight them. Visit the TAG Webstore or call us at 866-232-6477 for more information on our Choosing Hospice Flyer for Physicians, and take the next step in successful Hospice marketing.

*Scores are composite averages of multiple survey questions. 

2020: Refocus Your Vision Statement

December is a time to give thanks, deck the halls, evaluate your agency’s performance, and plan how to improve on it next year. Review every department: celebrate the areas that have surpassed their goals, and create a development plan for the areas that are falling short. If the same areas continue to fall short of their goals, it may be an indication that your vision statement needs revising.

Your vision statement should evolve as the guidelines and methodologies of home care, home health, and hospice care evolve. Listen to feedback from your nurses and your patients. Don’t limit your opportunity for growth or be blind to the need for change just because that change may not fit your current vision statement. 

Here’s some points to help evaluate the relevance of your vision statement:

1. Start with your staff.

   Provide your nurses and assistants the tools and training they need to perform efficiently in the field. Get their input on what they would like to see your agency accomplish in the coming year. According to a Forbes article by Joseph Folkman, staff members who buy into an agency’s vision are more engaged in their jobs, making them productive, satisfied, representatives of your agency. An engaged nursing staff will deliver quality care and promote higher CMS Quality of Patient Care and Patient Survey Ratings.

2. Never forget that home care is a people business, and people trust relationships.

   If your referrals are lacking, make sure your vision for 2020 includes relationship building; keep your face in front of the nurse practitioners, clinicians, and physicians referring patients to your agency.

3. Educate your referral partners.

   Never assume that your partners are aware of all you can do. Promote different areas of service on each visit. Ask how you can help them. Find out what their needs are and how you can offer support, i.e. Care plan Oversight or Transitional Care Management.

4. Stay relevant when marketing to physicians.

   Always promote your service as an extension of a physician’s care. Discuss improved patient outcomes, and share details about progressive care programs such as telemonitoring. If you don’t currently offer a telemonitoring program, consider offering it in the coming year.

5. Promote palliative and hospice care.

   In your vision for 2020, be mindful that the more people who are enlightened about symptom management, comfort care, and the support hospice provides patients and their families, the more people your agency will be able to serve.

As the terrain of home health and hospice care continue to change, there is no harm in adjusting your tread to improve your traction.

Have a safe, healthy and prosperous 2020, and remember TAG Partners is here to help!

“Vision statements should demonstrate how the world will be different now that your business is in it.”   ______ Shannon DeLong, House of Who