The CMS threshold, why hospices trip it, and what to change — starting this week.
Status: proposed, not final. These scores come from the SSVI file CMS published with the FY2027 Hospice Wage Index proposed rule (CMS-1851-P, April 2026). CMS is explicit that the SSVI is not a finding of fraud, waste, or abuse — it flags claims patterns that may warrant additional oversight.
25% of scored hospices nationally tripped this measure in FY2025.
This measure divides total skilled nursing minutes billed on hospice claims by total Routine Home Care days, giving an average minutes-per-day figure. A hospice at or below the 25th percentile nationally — roughly 10 minutes of nursing per RHC day or less — gets flagged. It is a proxy for visits that are too short or too infrequent to actually manage a terminal patient’s symptoms.
Percentile-based thresholds are recalculated by CMS every fiscal year, so the line moves as the industry moves.
No. This measure is nursing minutes only — RN or LPN — aide time is excluded.
The flag only catches the low tail of the distribution. The point of the measure is that roughly 10 minutes of nursing per RHC day, on average, signals visits too short or too rare to manage a terminal patient — not that more is always scored better above that line.
Related coverage: our news post on this measure.
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.
Friday, July 17 · 40 minutes · Hosted by Miles Pickens, Hospice Engine
Bring your score. We’ll walk through what’s driving it — spending, utilization flags, percentile rank — and what to change first. Zoom link sent by email when you register. The first 3 seats each Friday are free.
The Friday SSVI Q&A is free for the first 3 seats. For agency-specific work, book an SSVI consultation.