8 out of 10
CMS builds this single score out of ten separate indicators drawn from claims. A provider earns a point for each indicator where it is not an outlier against national thresholds. This one scores mid-range.
| Indicator | This provider | Read as |
|---|---|---|
| Visits near death | 96.1% | higher is better |
| Gaps in nursing visits | 2.3% | lower is better |
| Early live discharges | 0.0% | lower is better |
| Late live discharges | 36.8% | lower is better |
| Burdensome transitions, Type 1 | 5.3% | lower is better |
| Burdensome transitions, Type 2 | 10.5% | lower is better |
| Skilled nursing minutes on weekends | 4.8% | higher is better |
| Nurse care minutes per routine home care days | 12.50 min | higher is better |
| CHC/GIP provided | 0.0% | higher is better |
| Per-beneficiary spending | $19,256 | context, not a quality score |
Why live discharges matter. Hospice is for people expected to die within six months. A patient leaving hospice alive is sometimes the right outcome — they got better, or chose to resume curative treatment. But an unusually high rate can also indicate patients were enrolled who did not qualify, or were discharged when their care became expensive. CMS publishes early and late live-discharge rates for exactly this reason. Treat a high number as a question to ask, not a verdict.
| Practice | Patients receiving it | |
|---|---|---|
| Composite process measure (all seven care practices) | 100.0% | |
| Pain screening | 100.0% | |
| Shortness-of-breath screening | 100.0% | |
| Shortness-of-breath treatment | 100.0% | |
| Treatment preferences documented | 100.0% | |
| Beliefs and values addressed | 100.0% |
Share of patients for whom the provider documented each practice. These are process measures — they record whether something was done, not how well.
Average daily census: 25 patients.
| Owner | Role | Share | Associated since | CMS type flags |
|---|---|---|---|---|
| GREGORY SMITH | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 3/19/2023 | — |
| GREGORY SMITH | W-2 MANAGING EMPLOYEE | 100% | 5/15/2018 | — |
| MARK SHELTON | CONTRACTED MANAGING EMPLOYEE | — | 1/1/2025 | — |
| SHERRY SPIVEY | W-2 MANAGING EMPLOYEE | 100% | 3/7/2022 | — |
Source: CMS Hospice All Owners file, linked to this provider through its Medicare enrollment record. Medicare's Care Compare does not present ownership in this form.
Everything on this page is reproduced from the CMS Provider Data Catalog (July 2026 release) and, where shown, the CMS ownership and Medicare enrollment files. Nothing here is a rating or opinion of ours. If you believe a figure is wrong, email data@carerecords.org with the CCN and we verify against the official file within 5 business days.
How to cite this page: CareRecords, "Hand in Hand Hospice Care, LLC — hospice records, Natchitoches, LA." Compiled from the CMS Provider Data Catalog (July 2026 release), CCN 191690. https://carerecords.org/hospice/louisiana/hand-in-hand-hospice-care-llc-natchitoches/