The hospice provider data presented on CalQualityCare.org is the result of efforts by the Department of Social and Behavioral Sciences and the Institute for Health and Aging at the University of California, San Francisco (UCSF SBS/IHA), a nonprofit and public educational institution dedicated to improving health care quality.
UCSF SBS/IHA publishes CalQualityCare.org and oversees the development and maintenance of this website. UCSF SBS/IHA is also responsible for aggregating the data and compiling the ratings.
UCSF SBS/IHA is dedicated to advancing knowledge of health, illness, and medical illness through theory and research that evaluates the organization, financing, and delivery of health care; and to examine the broad dynamics of health policy and health care services. For more information, visit https://nursing.ucsf.edu/about/departments/social-and-behavioral-sciences.
The data on CalQualityCare.org come from the following California state and United States federal government sources, as well as from recognized accrediting organizations. The data have been gathered in various ways — including facility visits, self-reported data, and information submitted by clients or family members — and at different times. The data on CalQualityCare.org are updated quarterly with the most current information available.
Consumers should pay attention to the date data were collected, which can be accessed through the “more information” popup boxes found next to the data on each provider’s profile page (represented by a question mark button). While we make every effort to ensure the data are as current as possible, we are limited by how often the state and federal governments gather the information.
The data sources for hospice providers are:
- Program and ownership information: the California Department of Public Health’s Licensing and Certification Program, Electronic Licensing Management System (ELMS)
- Program characteristics, services, clients, staffing, and financial data: California Office of Statewide Health Planning and Development’s annual utilization report for Home Health Agencies and Hospices (CA OSHPD)
- Deficiency and complaint data: the federal CMS Certification and Survey Provider Enhanced Reporting (CMS CASPER) database
- Accreditation: the Accreditation Commission for Health Care (ACHC), Community Health Accreditation Program (CHAP), and The Joint Commission (JTC)
About the Ratings
CalQualityCare.org provides performance ratings for hospice programs in a single area: the Quality of Program. The rating is based on:
- Deficiencies and Complaints. The state surveys hospice programs at least every eight years to ensure that minimum federal standards of care and safety are being met. When a standard is not met, the program receives a “deficiency.” Deficiencies for violating federal standards fall under two categories: condition-level or standard-level deficiencies. Condition-level deficiencies are the most serious and indicate harm or the potential to harm clients. An agency is in danger of losing its certification if it does not correct the problem within 28 or 90 days, depending on severity. Standard-level deficiencies are less serious and require the agency to submit a plan of corrective action. Hospice programs may also receive a deficiency in response to a complaint substantiated by the state.
- OSHPD Annual Utilization Report (AUR). As part of their licensing, a hospice program is asked to report annually to the state information about the program and general information about the clients served. However there is no repercussion if a program does not submit a report. Compliance with this reporting requirement is a good sign of program quality.
- Accreditation. Accreditation means that a hospice program has been evaluated by a third party and meets certain standards of care. Accreditation is not required, but being accredited may indicate a hospice’s commitment to providing high-quality care. Once accredited, it is monitored to make sure it continues to meet the standards.
The Quality of Program rating methodology resulted in this distribution:
- Above Average: Hospice program had no deficiencies, a current OSHPD AUR, and no substantiated complaints (about 49% of hospice programs).
- Average: Hospice program had relatively few standard-level deficiencies, a current OSHPD AUR, and no substantiated complaints (about 24% of hospice programs).
- Below Average: Hospice program had relatively more standard-level deficiencies, did not have a current OSHPD AUR, and had two or more substantiated complaints (about 17% of hospice programs).
- Poor: Hospice program had one or more condition-level deficiency or had a significant number of standard-level deficiencies, did not have a current OSHPD AUR, and had two or more substantiated complaints. Also, hospice programs rated as poor and whose surveys are older than four years will continue to receive a poor rating if they have had a substantiated complaint and the program is not accredited (about 10% of hospice programs).
Because state surveys are so infrequent, no hospice programs are given a Superior rating.
For the specific deficiencies for a hospice program, see the California Department of Public Health’s Licensing and Certification Program (L&C).
Technical Guide to the Hospice Ratings
To read the complete ratings methodology for hospice care on CalQualityCare.org, download the PDF, “Technical Guide to the Hospice Ratings.”