The ranking
Percentages are the share of the 7,448 surveyed hospices in the file that received at least one citation under that CFR paragraph. Highlighted rows are requirements ComplyWell checks.
| # | Share | What was cited | Scale and tags |
|---|---|---|---|
| 1 | 57.2% | Plan of care missing required content | 10,867 citations · 4,261 hospices L0545–L0551 · 42 CFR 418.56(c) |
| 2 | 48.2% | Comprehensive assessment missing required content | 6,932 citations · 3,593 hospices L0524–L0532 · 42 CFR 418.54(c) |
| 3 | 39.1% | Hospice aide assignments and duties | 5,062 citations · 2,909 hospices L0625–L0628 · 42 CFR 418.76(g) |
| 4 | 32.1% | Coordination of services | 3,973 citations · 2,388 hospices L0554–L0558 · 42 CFR 418.56(e) |
| 5 | 28.8% | Clinical record content incomplete | 3,225 citations · 2,146 hospices L0672–L0678 · 42 CFR 418.104(a) |
| 6 | 21.5% | Infection prevention | 2,064 citations · 1,605 hospices L0579 · 42 CFR 418.60(a) |
| 7 | 20.0% | Discharge or transfer documentation | 2,335 citations · 1,491 hospices L0682–L0684 · 42 CFR 418.104(e) |
| 8 | 18.7% | Documents not signed (authentication) | 1,769 citations · 1,392 hospices L0679 · 42 CFR 418.104(b) |
| 9 | 17.5% | Plan of care not reviewed on schedule | 1,823 citations · 1,306 hospices L0552–L0553 · 42 CFR 418.56(d) |
| 10 | 16.9% | Comprehensive assessment not finished within five days | 1,537 citations · 1,256 hospices L0523 · 42 CFR 418.54(b) |
Four more sit just below the ten, and ComplyWell checks all four: the 14-day aide supervisory visit at 14.9% (42 CFR 418.76(h)), counseling and bereavement services at 12.8% (42 CFR 418.64(d)), the IDG plan of care record at 11.7% (42 CFR 418.56(b)) and the 15-day comprehensive assessment update at 11.2% (42 CFR 418.54(d)). Initial certification of terminal illness is cited at 6.8% (42 CFR 418.102(b)) and recertification at 4.2% (42 CFR 418.102(c)).
What this says about surveys
Two things stand out once the whole national file is counted rather than sampled.
The top of the list is documentation
Every one of the top ten is about what a record contains, whether it was signed, or whether a date was met. Some of them — the content of an assessment, an aide's assignments — need a clinician to fix. Others are dates and signatures, which is what a daily check is built for.
Frequency and severity are different questions
A condition-level citation is severe enough to threaten the agency's Medicare certification rather than being a standard-level finding. Those cluster differently from the ranking. The most, 1,102 condition-level citations at 684 hospices, fall under 42 CFR 418.56 — the interdisciplinary group, care planning and coordination of services — followed by 418.100, organization and administration, at 711 and 418.54, assessment, at 583. Frequency tells you what will probably happen. Condition level tells you what will hurt.
Where these numbers come from
The source is the full national CMS survey deficiency file for hospices, covering October 2021 to March 2026. It is a public file. We did not sample it, weight it, or model it: every figure on this page is a count.
Each citation is counted under the CFR paragraph the file records for it in its “Cited Regulation” column, and a hospice is one CMS Certification Number. Life safety code citations and survey initial-comment entries name no 42 CFR 418 paragraph, so they count toward the 86,113 total but not toward any row. The tags behind each row are listed so you can check it yourself.
The script that produces this ranking, the source file and the instructions for reproducing every number on this page are yours for the asking — email [email protected] and we send them. If a new release of the file moves these numbers, this page moves with it. The figures here are outputs, not marketing claims we chose.
What ComplyWell does about it
Four of the ten requirements above, and the four just below them, are rules ComplyWell checks every morning, for every patient, from the reports your EMR already produces.
Get Your Free Compliance Check See every hospice rule we check
Counts are from the full national CMS hospice survey deficiency file, October 2021 to March 2026. Regulation citations checked against the electronic Code of Federal Regulations. This page is compliance-support information, not legal advice.