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US · guidance

CMS SOM App. M, Tag L647

§418.78(e) Standard: Level of activity

activein force · 2026-07-22 – presentas-observed

Volunteers must provide day-to-day administrative and/or direct patient care

services in an amount that, at a minimum, equals 5 percent of the total patient care

hours of all paid hospice employees and contract staff. The hospice must maintain

records on the use of volunteers for patient care and administrative services,

including the type of services and time worked.

Interpretive Guidelines §418.78(e)

In computing this level of activity, the hospice divides the number of hours that hospice

volunteers spent providing administrative and/or direct patient care services by the total

number of patient care hours of all paid hospice employees and contract staff. For

example, if the hospice provides 10,000 hours of paid direct patient care during a one-year period the hospice must provide 500 volunteer hours in direct patient care or

administrative activities to meet the required 5 percent total.

A hospice may fluctuate the volume of care provided by volunteers after the hospice

meets the required 5 percent minimum.

History

Rev. 210; Issued:02-03-23; Effective:02-03-23; Implementation:02-03-23

Provenance

Source
cms.gov
Retrieved
2026-07-22
Edition
som-2026-07-22
Content hash
10b228ad2fd4a571ccc4969376286dca281be8c64bac3458b769160b8a607673
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