CMS Re-Specifies Hospice Visits in Last Days of Life Measure

The Centers for Medicare & Medicaid (CMS) has re-specified the Hospice Visits When Death is Imminent (HVWDII) measure. The re-specified measure, Hospice Visits in Last Days of Life (HVLDL), and was announced by CMS via the report Hospice Visits When Death is Imminent: Measure Validity Testing Summary and Re-Specifications (posted in September, 2020). HVLDL is a claims-based measure that  indicates the hospice provider’s proportion of patients who have received visits from a registered nurse or medical social worker (non-telephonically) on at least two out of the final three days of the patient’s life.  Hospices have had questions about the measure including calculation details and impact on Care Compare and future hospice submission requirements. 

NAHC is consolidating some of the history on the change to the HVLDL, the questions many hospices have and responses in this article, and providing links to previous NAHC Report articles and other resources for the HVLDL. 

Because CMS will utilize hospice claims for this measure, Section O of the HIS-Discharge record is no longer needed.  This is the section that captured the hospice visit data.  Therefore, CMS revised the HIS record to reflect the elimination of this section and updated the HIS Manual.  The final HIS Manual V3.00 is available as is the updated HIS-Admission (updated to reflect current reporting year) and HIS-Discharge documents. The HIS Manual V3.00 is effective as of February 16, 2021 and the HVLDL is effective with admissions and discharges 1/1/2021 and later. 

As reported previously, hospices may use and submit either V2.00 or V3.00 of the HIS-Discharge record for admissions and discharges on or after this date.  Both are accepted by the ASAP system at this time.  If V2.00 is submitted by a hospice, the ASAP system will not capture the visit information in Section O (CMS has stated it is not able to collect data it is not using).  Some hospices have decided to continue using this version of the HIS-Discharge for their own internal visit data analysis and have not reported any problems with submission.  CMS has not given a date as to when the ASAP system will no longer accept  HIS-Discharge V2.00.  

Members can follow the link below for some of the most frequently asked questions about the elimination of Section O from the HIS-Discharge and the HVLDL measure. 

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