AI-Powered Chart Review Built for Hospice Agencies
Review 100% of your hospice charts against Medicare Conditions of Participation and LCD requirements. Identify documentation gaps before surveyors do.
The Compliance Challenges Hospice Agencies Face
Regulatory scrutiny on hospice agencies continues to increase. Agencies without large compliance departments are especially vulnerable.
Medicare CoP Compliance
Meeting the CMS Conditions of Participation under 42 CFR §418 requires thorough documentation across every patient chart. Gaps in any area can lead to condition-level deficiencies.
State Survey Preparation
State surveys can occur with little notice. Agencies need continuous readiness, not just pre-survey scrambling.
Hospice LCD Requirements
Local Coverage Determinations define what Medicare will cover. Failing to meet LCD criteria for terminal prognosis documentation can trigger denials and audits.
CAHPS Score Impact
Documentation quality directly affects patient and family satisfaction. Consistent care plan updates and communication improve CAHPS outcomes.
Terminal Prognosis Documentation
Supporting a terminal prognosis of six months or less requires specific clinical evidence documented consistently across the care plan, physician narratives, and IDG notes.
Symptom Management Records
Surveyors closely examine whether symptoms are being assessed, documented, and managed according to the individualized plan of care.
Built Around Hospice Regulatory Standards
Seneca Shield's hospice chart review is designed around the CMS Conditions of Participation for hospice care (42 CFR §418). Every chart is evaluated against the specific documentation requirements that state surveyors and Medicare Administrative Contractors (MACs) use when auditing hospice agencies.
Our analysis addresses the risk areas identified in the OIG Work Plan for hospice, including general inpatient care utilization, long-stay hospice patients, and compliance with the hospice benefit period recertification requirements. We also flag patterns that align with PEPPER report indicators, helping agencies understand their risk profile before CMS does.
Common state survey deficiency patterns — including incomplete care plans, missing face-to-face encounter documentation, and inconsistent symptom management — are systematically checked across your entire census.
What Seneca Shield Reviews in Hospice Charts
- Terminal prognosis documentation and clinical evidence
- Care plan completeness and individualization
- IDG meeting notes and interdisciplinary coordination
- Face-to-face encounter documentation
- Physician narrative statements
- Symptom assessment and management documentation
- Medication profile accuracy and reconciliation
- Hospice aide supervision and competency records
- Bereavement care documentation
- Discharge and transfer documentation
- Benefit period recertification compliance
- LCD eligibility criteria alignment
Works with Your Hospice EHR
Seneca Shield supports almost every modern EHR — no disruption to your team's workflow.
Don't see your EHR? Contact us.
"Our eligibility reviews are tighter than they've ever been. We feel confident submitting claims knowing charts were screened against CMS standards."
Nana Sarpong
Hospice Administrator, Goodwin Hospice
Try It at No Risk
We'll review your hospice charts at no charge. If we don't find meaningful compliance findings, you don't pay.
Get Survey-Ready with Confidence
See what Seneca Shield finds in your hospice charts. Schedule a 30-minute demo and we'll review your real data.