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 looks at the share of your Routine Home Care days that fall on a weekend and had at least one skilled visit — nursing, medical social services, or therapy. A hospice at or below the 25th percentile nationally, roughly 4.8% or less, gets flagged. It is a direct proxy for a Monday-through-Friday care model that leaves patients uncovered on weekends.
Percentile-based thresholds are recalculated by CMS every fiscal year, so the line moves as the industry moves.
No — this measure only counts claims-based skilled visits, not phone triage.
The flag line is 4.8% of weekend RHC days with a skilled visit — for most census sizes, a modest, structured weekend rotation is enough to clear it.
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.