Following concerns raised by hospice organizations and state associations, the Centers for Medicare and Medicaid Services (CMS) paused the Hospice Special Focus Program (SFP) in early 2025 to review its structure and impact, but its potential implementation remains a key concern for hospice providers.
During an education session at the 2025 Axxess Growth, Innovation and Leadership Experience (AGILE), Linda Woodle, Director of Accreditation, Corporate at CHAP and Patricia D’Arena, Vice President of Clinical Excellence at Enhabit Home Health and Hospice, shared strategies for navigating the SFP, emphasizing the importance of being survey ready and meeting compliance standards.
Understanding the SFP
The pair opened the session by discussing the history of the SFP, detailing that the program was developed by CMS to monitor hospices that consistently perform poorly based on specific quality indicators. Sample indicators included patient outcomes and compliance with Medicare standards.
Organizations selected for the program would receive enhanced oversight, including more frequent inspections and support to improve care quality, ensuring that all hospices meet minimum standards and deliver safe and effective care to patients.
“Understanding the implications of being selected is essential for hospices to implement the necessary changes,” Woodle said.
While the program has been paused for now, Woodle noted that organizations should familiarize themselves with the criteria for SFP selection, given the continued scrutiny on hospice providers and the potential for future implementation of the SFP.
“We’re not sure how and when this will resurface,” Woodle said. “But we believe, based on the MedPAC information that there is going to be strong support for continued scrutiny and oversight of hospices.”
Stay Survey Ready
The pair emphasized that hospice organizations should always be prepared for surveyors. D’Arena further noted that leaders should be proactive in their approach to compliance and surveys, noting that leaders should complete an initial review of operations before a surveyor visits the organization.
“A lot of this is about awareness,” D’Arena said. “Giving the information to your team and yourself to be prepared.”
In addition to being proactive, D’Arena also laid out the following steps to ensure success and stay survey ready:”
1. Address complaints – “Every complaint that you receive in your organization needs to be taken seriously,” she said. “No matter how small or how large, we must follow up and document what you’ve done.”
2. Create a core team to meet surveyors – “We need to help our teams be ready,” she said. “Help them know what to expect.”
3. Know your survey history – “Review your previous survey results,” she said. “That surveyor is going to expect to see improvement or changes if there was a plan of correction put into place.”
4. Use technology to spread education – “We need to think innovatively about how to spread this [education] to our teams, because telling them once or twice does not help spread the culture of survey readiness,” she said.
5. Conduct home visits with staff – “Completing direct patient care visits is crucial and will absolutely prepare you for a survey,” she said.
The pair also highlighted the importance of QAPI or Quality Assessment and Performance Improvement. The pair shared that placing a concentrated effort on QAPI, as well as providing opportunities for clinicians to learn from one another, is a key driver of success.
“Celebrating success on performance improvement is so important,” Woodle said. “Taking that step uplifts morale, impacts their [the clinician’s] feelings about job performance and overall improves the culture around performance improvement.”
Age-Friendly Care
The pair concluded the session with a discussion on the Age-Friendly Health Systems Initiative, highlighting the four essential elements of the care model: what matters, medication, mentation and mobility.
For organizations considering this approach, Axxess recently received the Age-Friendly Care at Home Verification from CHAP (Community Health Accreditation Partner), reflecting alignment with the care model.
The speakers emphasized that adopting this care model can be used as an additional strategy for survey preparedness, noting that organizations who have implemented the model have seen improved patient outcomes and satisfaction, leading to better survey results.
“It really will help your agency,” D’Arena said. “The culture will improve, you’ll have better outcomes and those experience scores will definitely increase. It serves as a roadmap for clinicians.”
With more than 550 attendees, more than 50 sponsors and countless connections made, AGILE 2025 was a massive success for everyone. Click here to register for AGILE 2026, May 4-6 in Dallas.
