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Hospice Evaluation and Assessment Reporting Tool (HEART) 


The Secretary is required to establish procedures for making data available to the public and to ensure Hospices have the opportunity to review that data prior to public reporting. The current Hospice Quality Reporting Programs (QRP) began with data collection on October 1, 2012 for payment determination in fiscal year 2014. Current measures in the program include measures from both the Hospice Item Set (HIS) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Hospice Survey. CMS anticipates expanding the Hospice QRP over the next several years to include additional quality measures, and will work toward the implementation of a new comprehensive assessment instrument that will replace the current Hospice Item Set (HIS) data collection vehicle.

While it must be recognized that hospice care differs from other post-acute care (PAC) settings, there is a need to create a comprehensive assessment instrument for hospice care to align with other Post-Acute Care (PAC) settings, where feasible and practical. As such, objectives of a comprehensive assessment instrument must include the ability to establish goals of care that embrace the individual’s values and preferences, and are consistent with a person-centered approach that values the person and caregiver in the care continuum with an emphasis on physical, psychosocial, spiritual, and emotional support. 

Progress/Status Update

Hospice is currently the only PAC setting without a CMS-mandated assessment instrument. Efforts are currently underway to develop a comprehensive hospice assessment tool, the Hospice Evaluation and Assessment Reporting Tool (HEART), which better meets hospice providers’ needs and is mutually beneficial to hospice providers and CMS. Towards this goal, CMS convened a Technical Expert Panel meeting in Fall 2017 and, after further analysis, CMS began pilot testing (Pilot A) an early version of the HEART. To assure that we address concerns raised during Pilot A testing, further testing phases are being delayed at this time. CMS is working diligently to retool the HEART following the lessons learned from Pilot A.


Key concepts in developing a hospice assessment tool:

  • To understand the care needs of people through the dying process
  • To ensure the safety and comfort of individuals enrolled in hospice institutions nationwide

Currently we collect data at admission and discharge via HIS that are used to calculate measures in the Hospice Quality Reporting Program. We would like to replace HIS and capture interim data with a hospice assessment instrument in order to bridge the gap to achieve a fuller understanding of patient care needs.

Stakeholder Input:

There will be significant interaction between CMS and stakeholders, as we want the hospice assessment tool to meet stakeholder needs and be supported by users.  Our goal is to have a hospice assessment tool that enables providers to use it as part of the plan of care and CMS to calculate quality measures based on the data. To solicit comments from the public, we will be holding Special Open Door Forums (SODF).

Upcoming Schedule for 2018:

  • SODF September 2018
  • SODF December 2018