Discharges with a Length of Stay of 180+ Days SSVI Measure

25.4% of scored hospices nationally tripped this measure in FY2025.

What CMS measures

This measure looks at the share of all discharges — including deaths — where the patient’s lifetime length of stay reached 180 days or more. A hospice at or above the 75th percentile nationally gets flagged. CMS uses it as a proxy for admissions that may not have met the six-month terminal prognosis at the time of certification.

The flag threshold

• FY2025: Flagged at or above the 75th percentile: 33.3% or more of discharges had a length of stay of 180 days or more (≥33.3%).
• FY2024: Flagged at or above the 75th percentile: 33.1% or more (≥33.1%).

Percentile-based thresholds are recalculated by CMS every fiscal year, so the line moves as the industry moves.

Why hospices trip it

• Weak initial eligibility screening, especially for non-cancer diagnoses like dementia and general debility.
• Recertifications that restate the original narrative instead of documenting genuine continued decline.
• No structured, measurable decline documentation (weight, PPS/FAST, MAC) supporting the ongoing prognosis.

How to move it — changes you can start today

1. Turn every recert past 180 days into a physician-led eligibility review with measurable decline data this week — not a copy-forward template.
2. Audit your current census this week for patients past 180 days and start honest discharge planning conversations where decline cannot be documented.
3. Tighten admission documentation requirements for dementia and debility referrals starting with your next intake.
4. Track your 180-day-plus share monthly from billing data so you see the trend before CMS does.

Common questions

Is a long length of stay ever appropriate?

Yes — the measure compares your rate to the national 75th percentile, not any single patient’s stay. Some patients genuinely stabilize on hospice and live well past 180 days.

Do live discharges make this measure better or worse?

A live discharge after 200 days still counts as a 180-day-plus discharge here, and it also feeds directly into the Live Discharge Rate measure — the two often move together.

Where does your hospice stand?

Look up your score free — the breakdown shows your raw value on this exact measure next to the CMS threshold. Or browse scores by state.

All nine SSVI measures

• Non-hospice spending
• No CHC or GIP days
• Facility-based RHC days
• Last 2 days skilled visits
• Long length of stay (this page)
• Live discharge rate
• SN minutes per RHC day
• Weekend skilled visits
• 7-day return rate