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This month, CMS (Centers for Medicare & Medicaid Services) published a final rule to be affecting the Medicare payments to hospice providers.

As CMS proposed in April this year, the final rule will increase payments to hospices by 1.8% or $340 million in the fiscal year 2019. This update is excellent news because this is higher than the previous increase of only 1% for the hospice payments for the fiscal year 2018. The aggregate cap of annual CMS payments to hospices increased by 1.8% also to $29,205.44.

Hospice providers that do not meet the quality reporting requirements as set by the Hospice Quality Reporting Program (HQRP) will now receive a 2% reduction in their CMS payments. These requirements include the two reporting metrics from the Hospice Item Set (HIS) and the Hospice CAHPS® Survey.

This implementation changes the timeline that hospices need to submit data for the HIS to four and a half months following the end of each quarter in a calendar year starting January 1, 2019. There were minor changes to the evaluation categories to CMS’s Hospice Compare program.

The update also will formally recognize physician assistants as designated attending physicians in hospices starting in 2019. This is a welcome change for both hospice providers giving them more staffing flexibility and hospice patients giving them more access to quality caregivers.

Also, the recognition of physician assistants helps fill a growing care need gap of HPM physicians. As a study published this April in the Journal of Pain and Symptom Management noted the supply of specialist HPM physicians is currently not adequate to service the hospice patient population. More worrisome, the “current training capacity is insufficient to keep up with population growth and demand for services.” The foresight of CMS to add physician assistants will be beneficial to address this issue starting in 2019.

CMS has published a Fact Sheet with the highlights or you can read the entire Medicare Program rule update here.


"Prior to using Broda's Elite Tilt Recliner, there were issues with safety for getting the resident out of the chair, safety for staff lifting her in, either manual/mechanical; comfort, keeping her in the chair, inability to get her body over the sides.

The chair sides raise to prevent her from throwing her legs/body over the sides; same with the extra padding along her leg area that is raised. The tilt puts her buttock in a comfortable position, but also makes it extremely difficult to push out. The chair sides also swing out to assist with ease of the mechanical tilt.

Broda's chair has given her a reason to want to get up and she enjoys her chair now. When we are using the mechanical lift she remains calm because she wants to get in it and will stay longer safely and comfortably! Staff can safely lift and position her without worrying about injuring themselves."

J. C., Unit Manager, RN |Campobello Island, NB

We have not had any skin breakdown with our residents in the Broda's Elite Tilt Recliners since we started using them four years ago. We attribute this to the design of the straps allowing for moisture wicking as well as the ability to easily position recline position for pressure relief. We have not had any skin breakdown with our residents in the Broda's Elite Tilt Recliners since we started using them four years ago. We attribute this to the design of the straps allowing for moisture wicking as well as the ability to easily position recline position for pressure relief.

Mitch C.

" My father, enlisted in the Air Force and trained as a machine gunner on B17’s during WWII. Photographs of the “Flying Fortress” grace the walls of his room in the Kansas Veterans' Home in Winfield, Kansas where he has been living for the past 6 years.

For the first 2 years in the Veterans’ Home, my father used a power wheelchair for mobility and independence. But at the age of 82, with advances in his Parkinson's and dementia, his power wheel chair was taken away for safety concerns. He was provided with a standard issue VA manual wheelchair with no tilt or recline. His posture in that chair was terrible ... he was very slumped over and leaning to the side. Even his breathing was limited as a result of his poor posture. All he could do was stare at the floor. It was so disheartening to see him this way. I would have to kneel on the floor to see him eye-to-eye due to his hunched posture from Parkinson's disease.

In a fortunate twist of fate, it was determined that my father was an ideal candidate for a chair from Broda. And as a vested veteran, he qualified for the VA to fund the chair. He has now had a Broda chair for over 4 years!

Since he's been in the chair from Broda we can now sit beside him on visits and look at each other face-to-face. Being able to tilt back in the chair and look upward, he can enjoy watching John Wayne westerns in the VA lounge. He can even use the Broda chair when he travels by transport for dental appointments. He can stay in his chair for the bus ride and in the office, since the chair can be tilted enough for the dentist to work on his teeth.

Broda's chair has been a blessing for my father, his caregivers and my family. The chair improves his quality of life and I can't imagine him not being in it over the past few years. We are fortunate that the VA will fund Broda chairs for Veterans like him who need them."

Kent P., Family Member

"My mother has osteoporosis and arthritis with muscle weakness and bone and joint discomfort- Since she received this new Latitude Pedal Rocker she has total comfort and less anxiety with increased mobility with the hopes of muscle and bone strengthening as she lost her ability to ambulate more than a few steps on her good days these last few months. She is legally blind seeing only light and dark these last 2 years. She just celebrated her 96th birthday and lived alone until age 93-This chair has met her very important needs of comfort, safety, strengthening, mobility."

Elaine R., Family Member |WI, USA

“What a difference now that Mom is safe and comfortable. It gives me peace of mind to know that she is sitting in one of Broda's chairs. My only regret is that I did not get this chair sooner for her.”

Bill L., Family Member ; fmr. Executive Director of Canadian Assistive Devices Association |Toronto, ON