No Continuous Home Care or General Inpatient Days SSVI Measure

45.1% of scored hospices nationally tripped this measure in FY2025.

What CMS measures

This is the only SSVI flag that is not a percentile cutoff — it is binary. If a hospice bills zero Continuous Home Care (CHC) hours and zero General Inpatient Care (GIP) days across the entire fiscal year, it earns the point. CMS reads a hospice that never once escalates a patient to a higher level of care as one that is not managing symptom crises the way the benefit is designed to.

The flag threshold

• FY2025: Flagged if the hospice billed zero Continuous Home Care hours AND zero General Inpatient Care days for the entire fiscal year.
• FY2024: Same structural test — zero CHC hours and zero GIP days for the entire fiscal year.

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

Why hospices trip it

• No GIP contract in place with a hospital or skilled nursing facility, so there is nowhere to send a patient in crisis.
• Nurses not trained to recognize or document CHC-eligible symptom crises, so everything gets managed at Routine Home Care.
• Fear of higher-level-of-care audits leading staff to avoid billing CHC or GIP even when a patient qualifies.

How to move it — changes you can start today

1. Sign a GIP contract with at least one hospital or SNF this week — the flag is about having and using the capability, not volume.
2. Train clinical staff this week on the CHC 8-hour predominantly-nursing rule and stand up a symptom-crisis protocol that automatically triggers a CHC evaluation.
3. Audit your last 10 deaths for crisis episodes that were managed at routine level but met CHC criteria on paper.
4. Require the level-of-care decision to be documented at every symptom crisis, even the ones where Routine Home Care turns out to be the right call.

Common questions

Does billing one single GIP day clear this flag?

Yes. The measure is binary — any CHC hours or GIP days at all during the year moves you off this flag, regardless of how much.

Is CHC or GIP riskier to bill than staying at Routine Home Care?

Both levels of care get audited and both require solid documentation to support them. But CMS has now made never using them its own red flag, so the safer path is billing the level of care that matches the patient’s condition and documenting it well.

Related coverage: our news post on this measure.

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 (this page)
• Facility-based RHC days
• Last 2 days skilled visits
• Long length of stay
• Live discharge rate
• SN minutes per RHC day
• Weekend skilled visits
• 7-day return rate