The Hospice Special Focus Program (SFP), established by the Centers for Medicare & Medicaid Services (CMS), aims to enhance the quality of hospice care by identifying and closely monitoring providers that fall short of established standards. Hospices selected for the SFP undergo more frequent surveys and may face additional penalties if they fail to improve.
Recent Developments
As of February 14, 2025, the Trump Administration has suspended the implementation of the Hospice Special Focus Program for the 2025 calendar year. This decision allows CMS to further evaluate the program’s effectiveness and methodology. The suspension was announced on the CMS website, indicating that the program’s implementation for 2025 has ceased to facilitate a more thorough assessment.
Background
The SFP was introduced to address concerns about the quality of care provided by certain hospices. It was designed to identify underperforming hospices through a combination of survey findings and quality indicators. Hospices selected for the program were subject to more frequent surveys and potential penalties if they did not meet improvement criteria. However, the methodology for selecting hospices for the SFP has faced criticism from various stakeholders.
Legal Challenges
In January 2025, a group of hospice providers and state associations filed a lawsuit against the U.S. Department of Health and Human Services (HHS) over the implementation of the SFP. The plaintiffs argue that the program’s methodology is flawed, potentially misidentifying high-quality providers as underperformers and diverting resources away from patient care. They seek a preliminary injunction to halt the program’s implementation.
Implications
The suspension of the SFP provides an opportunity for CMS to reassess the program’s design and implementation. Stakeholders, including hospice providers and patient advocacy groups, have expressed concerns about the program’s impact on patient care and the accuracy of its assessments. The ongoing legal challenges highlight the need for a balanced approach that ensures quality care without unfairly penalizing providers.
Conclusion
The suspension of the Hospice Special Focus Program marks a significant development in the ongoing efforts to improve hospice care quality. As CMS evaluates the program’s effectiveness, it is crucial to consider the perspectives of all stakeholders to develop a system that accurately identifies underperforming hospices while supporting those committed to providing high-quality end-of-life care.
About the Author
Lisa Selman-Holman, Vice President of Clinical Services
Lisa Selman-Holman, JD, BSN, RN, HCS-D, COS-C, is the VP of Clinical Services at McBee, bringing over 35 years of expertise in home health and hospice. As a registered nurse and home care attorney, she specializes in regulatory compliance. Lisa has held various roles, from field nurse to executive, managing accreditation surveys, acquisitions, and regulatory crises. In 2004, she founded Selman-Holman & Associates, offering consulting, coding and OASIS review services. Lisa is a renowned educator, known for turning challenges into achievements. Joining McBee in 2021, she leads education initiatives at the Post-Acute Academy, providing courses for home health and hospice staff and executives, including clinical, regulatory and onboarding requirements.
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